Provider Demographics
NPI:1588095020
Name:GHATE, NAMITA (DPT)
Entity type:Individual
Prefix:
First Name:NAMITA
Middle Name:
Last Name:GHATE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25229 S SUN LAKES BLVD
Mailing Address - Street 2:STE 119
Mailing Address - City:SUN LAKES
Mailing Address - State:AZ
Mailing Address - Zip Code:85248-6453
Mailing Address - Country:US
Mailing Address - Phone:480-883-6734
Mailing Address - Fax:480-895-8143
Practice Address - Street 1:25229 S SUN LAKES BLVD
Practice Address - Street 2:STE 119
Practice Address - City:SUN LAKES
Practice Address - State:AZ
Practice Address - Zip Code:85248-6453
Practice Address - Country:US
Practice Address - Phone:480-883-6734
Practice Address - Fax:480-895-8143
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-10
Last Update Date:2013-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8380225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist