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NPI Code Detail

MEDICARE: MRS. KALYANI VAIBHAV GARDE M.S. OTR/L

MEDICARE: MRS. KALYANI VAIBHAV GARDE M.S. OTR/L
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
1225X00000XOccupational TherapistOT0000002891TN

General Provider Information

NPI Number : 1114110657
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KALYANI VAIBHAV GARDE M.S. OTR/L
Provider Business Mailing Address
First Line : 8967 ASHMERE DR
Second Line :
City : GERMANTOWN
State : TN
Zip : 38139-6601
Country : US
Telephone Number : 901-309-5298
Fax Number :
Provider Business Practice Location Address
First Line : 6320 N QUAIL HOLLOW RD
Second Line :
City : MEMPHIS
State : TN
Zip : 38120-1420
Country : US
Telephone Number : 901-761-0021
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2007
Last Update Date : 12/11/2011

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