Provider Demographics
NPI:1548704380
Name:KULKARNI, ROOPA (PT)
Entity type:Individual
Prefix:
First Name:ROOPA
Middle Name:
Last Name:KULKARNI
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 1:1077 SOUTHGATE DR
Mailing Address - Street 2:
Mailing Address - City:BRAZIL
Mailing Address - State:IN
Mailing Address - Zip Code:47834-7588
Mailing Address - Country:US
Mailing Address - Phone:859-420-8288
Mailing Address - Fax:
Practice Address - Street 1:1077 SOUTHGATE DR
Practice Address - Street 2:
Practice Address - City:BRAZIL
Practice Address - State:IN
Practice Address - Zip Code:47834-7588
Practice Address - Country:US
Practice Address - Phone:859-420-8288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-13
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05012292A225100000X
IL070021809225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist