Provider Demographics
NPI:1720559776
Name:HINHORIYA, PINAKIN RAMESHBHAI
Entity Type:Individual
Prefix:
First Name:PINAKIN
Middle Name:RAMESHBHAI
Last Name:HINHORIYA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47105 LIBERTY BELL RD E
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48044-2574
Mailing Address - Country:US
Mailing Address - Phone:248-688-1755
Mailing Address - Fax:
Practice Address - Street 1:47105 LIBERTY BELL RD E
Practice Address - Street 2:
Practice Address - City:MACOMB
Practice Address - State:MI
Practice Address - Zip Code:48044-2574
Practice Address - Country:US
Practice Address - Phone:248-688-1755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-16
Last Update Date:2018-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501014722225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5501014722Medicaid