Provider Demographics
NPI:1013242643
Name:DESHPANDE, RADHIKA RANGNATH (PT)
Entity Type:Individual
Prefix:
First Name:RADHIKA
Middle Name:RANGNATH
Last Name:DESHPANDE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:724 BERMUDA DR
Mailing Address - Street 2:
Mailing Address - City:BRANCHBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08853-4276
Mailing Address - Country:US
Mailing Address - Phone:908-635-1350
Mailing Address - Fax:
Practice Address - Street 1:904 OAK TREE AVE
Practice Address - Street 2:SUITE S
Practice Address - City:SOUTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07080-5126
Practice Address - Country:US
Practice Address - Phone:908-756-6555
Practice Address - Fax:908-756-9754
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-15
Last Update Date:2009-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01325800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist