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General NPI Number Information
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NPI Number | 1962738682
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Entity Type | Individual
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Provider Name | SHANTHA V PAI OTR
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Gender | Female
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Dates
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Enumeration Date | 10/30/2009
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Last Update Date | 10/30/2009
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Provider Practice Location Address
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Address Line | 67 UNION ST
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City | NATICK
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State | MA
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Zip | 01760-7700
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Country | US
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Telephone | 508-650-7630
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Fax |
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Provider Business Mailing Address
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Address Line | 17 WOODBINE RD # 3
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City | NATICK
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State | MA
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Zip | 01760-4013
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Country | US
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Telephone | 508-655-5174
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 9843
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License Number State | MA
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