MEDICARE: MISS ANJANI DURISETY

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
1	225100000X	Physical Therapist	40582	CA
2	225100000X	Physical Therapist	032427	NY

General Provider Information

NPI Number	:	1356611685
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS ANJANI DURISETY

Provider Business Mailing Address
First Line	:	437 MAYTEN WAY
Second Line	:
City	:	FREMONT
State	:	CA
Zip	:	94539-7630
Country	:	US
Telephone Number	:	408-406-7046
Fax Number	:

Provider Business Practice Location Address
First Line	:	437 MAYTEN WAY
Second Line	:
City	:	FREMONT
State	:	CA
Zip	:	94539-7630
Country	:	US
Telephone Number	:	408-406-7046
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/03/2012
Last Update Date	:	07/18/2023

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Directions to “ MISS ANJANI DURISETY ” Practice Location

Language	Start Address	Practice Location

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