Healthcare Provider Details

I. General information

NPI: 1073084257
Provider Name (Legal Business Name): DEEPALI BATISH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2018
Last Update Date: 12/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 HARRIS RD
NASHUA NH
03062-2145
US

IV. Provider business mailing address

3000 GOFFS FALLS RD STE 101
MANCHESTER NH
03103-6109
US

V. Phone/Fax

Practice location:
  • Phone: 603-888-1573
  • Fax:
Mailing address:
  • Phone: 800-995-2673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number4356
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: