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NPI Code Detail

MEDICARE: INDIA HERTEL

MEDICARE: INDIA HERTEL
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
1103K00000XBehavior Analyst1305-140WI

General Provider Information

NPI Number : 1528669983
Entity Type Code : Individual
Provider Name (Legal Business Name) : INDIA HERTEL
Provider Business Mailing Address
First Line : 11709 W CLEVELAND AVE
Second Line :
City : WEST ALLIS
State : WI
Zip : 53227-2901
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1021 W NATIONAL AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53204-1347
Country : US
Telephone Number : 920-393-8320
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2020
Last Update Date : 01/05/2026

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Directions to “ INDIA HERTEL ” Practice Location

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