Provider Demographics
NPI:1982065207
Name:JOSHI, SURALI
Entity Type:Individual
Prefix:
First Name:SURALI
Middle Name:
Last Name:JOSHI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 MICKLEY RUN APTS APT D
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:PA
Mailing Address - Zip Code:18052-7913
Mailing Address - Country:US
Mailing Address - Phone:610-597-6490
Mailing Address - Fax:
Practice Address - Street 1:272 BRODHEAD RD
Practice Address - Street 2:SUITE 600
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-8956
Practice Address - Country:US
Practice Address - Phone:610-625-4959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-14
Last Update Date:2016-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA013232225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist