Provider Demographics
NPI:1447967542
Name:JOSHI, SUNIL KUMAR (DPT)
Entity type:Individual
Prefix:
First Name:SUNIL
Middle Name:KUMAR
Last Name:JOSHI
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2212 CERREIA WAY
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46814-8867
Mailing Address - Country:US
Mailing Address - Phone:660-221-7827
Mailing Address - Fax:
Practice Address - Street 1:2212 CERREIA WAY
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46814-8867
Practice Address - Country:US
Practice Address - Phone:660-221-7827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05012182A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist