Provider Demographics
NPI:1902095250
Name:SARAVANAN, RAJESH
Entity Type:Individual
Prefix:
First Name:RAJESH
Middle Name:
Last Name:SARAVANAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:668 CUMBERLAND AVE APT D
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-3869
Mailing Address - Country:US
Mailing Address - Phone:203-506-5270
Mailing Address - Fax:
Practice Address - Street 1:668 CUMBERLAND AVE APT D
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-3869
Practice Address - Country:US
Practice Address - Phone:203-506-5270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-22
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028627225100000X
IN05009141A225100000X
PAPT018549225100000X
CT008080225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist