Provider Demographics
NPI:1235476383
Name:BABA, HAFSA (PT)
Entity type:Individual
Prefix:MISS
First Name:HAFSA
Middle Name:
Last Name:BABA
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 1:1840 NATIONAL AVE APT 108
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46227-3384
Mailing Address - Country:US
Mailing Address - Phone:317-441-3868
Mailing Address - Fax:
Practice Address - Street 1:7840 E US HIGHWAY 36 STE A
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-7155
Practice Address - Country:US
Practice Address - Phone:317-441-3868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-09
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05011016A225100000X
NY035802225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist