Provider Demographics
NPI:1790183325
Name:JOSHI, PRAJAKTA
Entity Type:Individual
Prefix:
First Name:PRAJAKTA
Middle Name:
Last Name:JOSHI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1556
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-3556
Mailing Address - Country:US
Mailing Address - Phone:919-372-0326
Mailing Address - Fax:919-551-7507
Practice Address - Street 1:1600 OLIVE CHAPEL RD STE 108
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-6765
Practice Address - Country:US
Practice Address - Phone:919-372-0326
Practice Address - Fax:919-551-7507
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-13
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC146102251G0304X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics