MEDICARE: MRS. VALLABHA SUDHIR KSHIRSAGAR PT OCS CHT

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	PT 4293	OH
2	2251H1200X	Hand Physical Therapist	1041100163	OH
3	2251X0800X	Orthopedic Physical Therapist	8218	OH

Other Identifiers

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

General Provider Information

NPI Number	:	1568463271
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. VALLABHA SUDHIR KSHIRSAGAR PT OCS CHT

Provider Business Mailing Address
First Line	:	4440 GLEN ESTE WITHAMSVILLE ROAD
Second Line	:	SUITE 1500
City	:	CINCINNATI
State	:	OH
Zip	:	45245
Country	:	US
Telephone Number	:	513-753-2133
Fax Number	:	513-753-1804

Provider Business Practice Location Address
First Line	:	4440 GLEN ESTE WITHAMSVILLE RD
Second Line	:	SUITE 1500
City	:	CINCINNATI
State	:	OH
Zip	:	45245
Country	:	US
Telephone Number	:	513-753-2133
Fax Number	:	513-753-1804

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

Provider Enumeration Date	:	08/03/2005
Last Update Date	:	02/12/2008

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