Provider Demographics
NPI:1326344102
Name:DESHMUKH, PRIYANKA (PT)
Entity type:Individual
Prefix:
First Name:PRIYANKA
Middle Name:
Last Name:DESHMUKH
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 1:10294 E 96TH ST
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-9497
Mailing Address - Country:US
Mailing Address - Phone:317-288-7572
Mailing Address - Fax:317-284-1765
Practice Address - Street 1:10294 E 96TH ST
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037-9497
Practice Address - Country:US
Practice Address - Phone:317-288-7572
Practice Address - Fax:317-284-1765
Is Sole Proprietor?:No
Enumeration Date:2011-01-27
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05009537A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist