MEDICARE: ROHINI SUHAS GHATGE DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT023002	PA

General Provider Information

NPI Number	:	1043642721
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROHINI SUHAS GHATGE DPT

Provider Business Mailing Address
First Line	:	11070 CATHELL RD STE 4
Second Line	:
City	:	BERLIN
State	:	MD
Zip	:	21811-9344
Country	:	US
Telephone Number	:	410-208-3630
Fax Number	:

Provider Business Practice Location Address
First Line	:	1208 TASKER ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19148-1019
Country	:	US
Telephone Number	:	215-271-4100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2013
Last Update Date	:	08/05/2013

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