Provider Demographics
NPI:1932301926
Name:RAMANUJAM, JAYAPRASANNA (OTR)
Entity Type:Individual
Prefix:MR
First Name:JAYAPRASANNA
Middle Name:
Last Name:RAMANUJAM
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 CAMBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:KOKOMO
Mailing Address - State:IN
Mailing Address - Zip Code:46902-4980
Mailing Address - Country:US
Mailing Address - Phone:765-210-8098
Mailing Address - Fax:
Practice Address - Street 1:605 CAMBRIDGE DR
Practice Address - Street 2:
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46902-4980
Practice Address - Country:US
Practice Address - Phone:765-210-8098
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31003994A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist