Provider Demographics
NPI:1689020869
Name:GROVER, DEEPALI MADAAN (PT, MPT)
Entity Type:Individual
Prefix:
First Name:DEEPALI
Middle Name:MADAAN
Last Name:GROVER
Suffix:
Gender:F
Credentials:PT, MPT
Other - Prefix:
Other - First Name:DEEPALI
Other - Middle Name:
Other - Last Name:MADAAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 179
Mailing Address - Street 2:
Mailing Address - City:FOREST HILL
Mailing Address - State:MD
Mailing Address - Zip Code:21050-0179
Mailing Address - Country:US
Mailing Address - Phone:410-692-2941
Mailing Address - Fax:410-648-4878
Practice Address - Street 1:4105 NORRISVILLE RD UNIT 7
Practice Address - Street 2:
Practice Address - City:WHITE HALL
Practice Address - State:MD
Practice Address - Zip Code:21161-9308
Practice Address - Country:US
Practice Address - Phone:410-692-2941
Practice Address - Fax:410-692-6073
Is Sole Proprietor?:No
Enumeration Date:2016-05-06
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25739225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist