Provider Demographics
NPI:1023061033
Name:CHOPRA, SANJEEV (OTR/L)
Entity type:Individual
Prefix:MR
First Name:SANJEEV
Middle Name:
Last Name:CHOPRA
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 HERON RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-0723
Mailing Address - Country:US
Mailing Address - Phone:336-317-9233
Mailing Address - Fax:866-399-1515
Practice Address - Street 1:1750 HERON RIDGE DR
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-0723
Practice Address - Country:US
Practice Address - Phone:336-317-9233
Practice Address - Fax:866-399-1515
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201000982225XG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA497617Medicare Oscar/Certification