Provider Demographics
NPI:1821532920
Name:NAJAF, KANWAL (PTA)
Entity Type:Individual
Prefix:
First Name:KANWAL
Middle Name:
Last Name:NAJAF
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1915 WILSHIRE ST
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48186-5404
Mailing Address - Country:US
Mailing Address - Phone:734-757-0805
Mailing Address - Fax:734-629-8288
Practice Address - Street 1:1915 WILSHIRE ST
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48186-5404
Practice Address - Country:US
Practice Address - Phone:734-757-0805
Practice Address - Fax:734-629-8288
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-07
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5502002846225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant