Provider Demographics
NPI:1942572979
Name:MUKHERJEE, ANUSHREE (PT)
Entity Type:Individual
Prefix:
First Name:ANUSHREE
Middle Name:
Last Name:MUKHERJEE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ANUSHREE
Other - Middle Name:
Other - Last Name:MEHTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1845 MIDCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48324-1138
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2300 GRAND HAVEN DR
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48083-4418
Practice Address - Country:US
Practice Address - Phone:248-588-9444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-07
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist