Provider Demographics
NPI:1942506720
Name:SATAPATHY, DIPTI
Entity Type:Individual
Prefix:
First Name:DIPTI
Middle Name:
Last Name:SATAPATHY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:NA
Other - Middle Name:NA
Other - Last Name:NA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:44563 WHITE PINE CIR W
Mailing Address - Street 2:
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48168-4357
Mailing Address - Country:US
Mailing Address - Phone:734-250-3684
Mailing Address - Fax:248-773-5070
Practice Address - Street 1:44563 WHITE PINE CIR W
Practice Address - Street 2:
Practice Address - City:NORTHVILLE
Practice Address - State:MI
Practice Address - Zip Code:48168-4357
Practice Address - Country:US
Practice Address - Phone:734-250-3684
Practice Address - Fax:248-773-5070
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-27
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501008442225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist