Provider Demographics
NPI:1962738682
Name:PAI, SHANTHA V (OTR)
Entity type:Individual
Prefix:MS
First Name:SHANTHA
Middle Name:V
Last Name:PAI
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 WOODBINE RD
Mailing Address - Street 2:# 3
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-4013
Mailing Address - Country:US
Mailing Address - Phone:508-655-5174
Mailing Address - Fax:
Practice Address - Street 1:67 UNION ST
Practice Address - Street 2:
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-7700
Practice Address - Country:US
Practice Address - Phone:508-650-7630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-30
Last Update Date:2009-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9843225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist