Provider Demographics
NPI:1912916057
Name:NAIDU, JYOTI RAJU (OTR/L, CHT)
Entity Type:Individual
Prefix:
First Name:JYOTI
Middle Name:RAJU
Last Name:NAIDU
Suffix:
Gender:F
Credentials:OTR/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 CHESTNUT ST
Mailing Address - Street 2:5TH FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-4216
Mailing Address - Country:US
Mailing Address - Phone:267-339-3500
Mailing Address - Fax:215-503-0580
Practice Address - Street 1:235 W LANCASTER AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:DEVON
Practice Address - State:PA
Practice Address - Zip Code:19333-1560
Practice Address - Country:US
Practice Address - Phone:610-688-6767
Practice Address - Fax:610-688-3224
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC0092292251H1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251H1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAOC009229OtherLICENSE