Provider Demographics
NPI:1427252477
Name:MIRCHANDANI, HARSHA (MPT)
Entity type:Individual
Prefix:MRS
First Name:HARSHA
Middle Name:
Last Name:MIRCHANDANI
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1747 ABBOTSFORD CT
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28056-7430
Mailing Address - Country:US
Mailing Address - Phone:704-824-1582
Mailing Address - Fax:704-824-7981
Practice Address - Street 1:111 HARRILSON RD
Practice Address - Street 2:
Practice Address - City:CHERRYVILLE
Practice Address - State:NC
Practice Address - Zip Code:28021-9541
Practice Address - Country:US
Practice Address - Phone:704-435-0108
Practice Address - Fax:704-435-4982
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8726225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2251500000XMedicare ID - Type UnspecifiedLPT