Healthcare Provider Details

I. General information

NPI: 1902427800
Provider Name (Legal Business Name): SANKET NAIK
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2020
Last Update Date: 02/17/2025
Certification Date: 02/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 N MAIN ST
RUSHVILLE IN
46173-1198
US

IV. Provider business mailing address

1300 N MAIN ST
RUSHVILLE IN
46173-1198
US

V. Phone/Fax

Practice location:
  • Phone: 765-932-7498
  • Fax: 765-932-7411
Mailing address:
  • Phone: 765-932-4111
  • Fax: 765-932-7505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number05011032A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: