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NPI Code Detail

MEDICARE: MR. ANJANJYOTI BARUAH OTR/L

MEDICARE:  MR. ANJANJYOTI  BARUAH  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 TherapistOT12577FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1356611255
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ANJANJYOTI BARUAH OTR/L
Provider Business Mailing Address
First Line : 502 CANDLEBARK DR
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32225-5358
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 11565 HARTS RD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32218-3777
Country : US
Telephone Number : 904-751-1834
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2012
Last Update Date : 01/09/2012

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Directions to “ MR. ANJANJYOTI BARUAH OTR/L” Practice Location

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