Provider Demographics
NPI:1861135154
Name:BANGAR, TEJASWINI SHIVANAND (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:TEJASWINI
Middle Name:SHIVANAND
Last Name:BANGAR
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7819 LINDEN ST
Mailing Address - Street 2:
Mailing Address - City:DYER
Mailing Address - State:IN
Mailing Address - Zip Code:46311-2465
Mailing Address - Country:US
Mailing Address - Phone:219-488-7534
Mailing Address - Fax:
Practice Address - Street 1:5620 SOHL AVE
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:IN
Practice Address - Zip Code:46320-2008
Practice Address - Country:US
Practice Address - Phone:219-245-2230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-15
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist