Provider Demographics
NPI:1770516940
Name:RAJE, MEENAL (PT)
Entity type:Individual
Prefix:MS
First Name:MEENAL
Middle Name:
Last Name:RAJE
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 1:9711 GLENFIELD CT
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45458-9175
Mailing Address - Country:US
Mailing Address - Phone:937-885-7305
Mailing Address - Fax:937-885-7365
Practice Address - Street 1:4760 FISHBURG RD STE C
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45424-5461
Practice Address - Country:US
Practice Address - Phone:937-237-0400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3087225100000X
MI5501003044225100000X
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist