Provider Demographics
NPI:1730144205
Name:BAKSHI, ASHIM (OTR CHT)
Entity Type:Individual
Prefix:MR
First Name:ASHIM
Middle Name:
Last Name:BAKSHI
Suffix:
Gender:M
Credentials:OTR CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:486 S DOBBS GLEN
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47803
Mailing Address - Country:US
Mailing Address - Phone:812-877-7260
Mailing Address - Fax:
Practice Address - Street 1:4414 S 7TH ST
Practice Address - Street 2:STE C
Practice Address - City:TERRA HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47802
Practice Address - Country:US
Practice Address - Phone:812-299-9281
Practice Address - Fax:812-299-2142
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31002061A225X00000X
225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Not Answered225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
156613Medicare ID - Type Unspecified