Provider Demographics
NPI:1104301324
Name:MORABIA, SIDDHI SURESH
Entity type:Individual
Prefix:
First Name:SIDDHI
Middle Name:SURESH
Last Name:MORABIA
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 1:8535 MAPLE TREE DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-4554
Mailing Address - Country:US
Mailing Address - Phone:909-662-7992
Mailing Address - Fax:
Practice Address - Street 1:2640 COLD SPRING RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46222-2272
Practice Address - Country:US
Practice Address - Phone:909-662-7992
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-03
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist