Provider Demographics
NPI:1801838156
Name:HAJRATWALA, BADHRAKUMARI (PT)
Entity type:Individual
Prefix:MRS
First Name:BADHRAKUMARI
Middle Name:
Last Name:HAJRATWALA
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 1:847 E ANGELA ST
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-7568
Mailing Address - Country:US
Mailing Address - Phone:925-846-3521
Mailing Address - Fax:925-846-3811
Practice Address - Street 1:2805 WHIPPLE RD
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:CA
Practice Address - Zip Code:94587-1233
Practice Address - Country:US
Practice Address - Phone:510-441-8906
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25433225100000X
MI5501002284225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOH25777Medicare ID - Type UnspecifiedPT PROVIDER NUMBER