Provider Demographics
NPI:1730534033
Name:GANDHI, MILI (MPT)
Entity type:Individual
Prefix:
First Name:MILI
Middle Name:
Last Name:GANDHI
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:MILI
Other - Middle Name:
Other - Last Name:ASHOK LAPSIWALA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:PO BOX 3497
Mailing Address - Street 2:
Mailing Address - City:STURTEVANT
Mailing Address - State:WI
Mailing Address - Zip Code:53177-0300
Mailing Address - Country:US
Mailing Address - Phone:877-552-2996
Mailing Address - Fax:866-245-8064
Practice Address - Street 1:2525 S TELEGRAPH RD
Practice Address - Street 2:SUITE 314
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-0286
Practice Address - Country:US
Practice Address - Phone:248-499-6441
Practice Address - Fax:248-977-3751
Is Sole Proprietor?:No
Enumeration Date:2016-04-25
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501012131225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIMI6023004Medicare PIN