Provider Demographics
NPI:1922252329
Name:NANDIPATI, HEMKANTH (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:HEMKANTH
Middle Name:
Last Name:NANDIPATI
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:HEMKANTH
Other - Middle Name:
Other - Last Name:NANDIPATI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHYSICAL THERAPIST
Mailing Address - Street 1:12 WHITNEY LN
Mailing Address - Street 2:
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-2070
Mailing Address - Country:US
Mailing Address - Phone:203-535-6923
Mailing Address - Fax:
Practice Address - Street 1:2319 WHITNEY AVE
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518-3509
Practice Address - Country:US
Practice Address - Phone:203-288-1623
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-11
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT008087225100000X
MI5501013786225100000X
IN05009529A225100000X
NY0292441225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist