MEDICARE: GEETA BHOJWANI OTR

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	225X00000X	Occupational Therapist	2771-026	WI

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	:	1902079049
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEETA BHOJWANI OTR

Provider Business Mailing Address
First Line	:	2440 WANDERING SPRINGS CIR
Second Line	:
City	:	GREEN BAY
State	:	WI
Zip	:	54311-5572
Country	:	US
Telephone Number	:	920-406-9135
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 S BROADWAY
Second Line	:
City	:	GREEN BAY
State	:	WI
Zip	:	54303-1516
Country	:	US
Telephone Number	:	920-391-2427
Fax Number	:

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

Provider Enumeration Date	:	04/09/2008
Last Update Date	:	04/09/2008

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