Provider Demographics
NPI:1811595960
Name:KANAKE, DNYANESH PRANAY (OT/L)
Entity Type:Individual
Prefix:
First Name:DNYANESH
Middle Name:PRANAY
Last Name:KANAKE
Suffix:
Gender:M
Credentials:OT/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:STURBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01566-1112
Mailing Address - Country:US
Mailing Address - Phone:413-426-1711
Mailing Address - Fax:
Practice Address - Street 1:10 RIVER RD
Practice Address - Street 2:
Practice Address - City:STURBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01566-1112
Practice Address - Country:US
Practice Address - Phone:413-426-1711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-12
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA12098225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist