Basic Information
Provider Information
NPI: 1033236427
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TARHALKAR
FirstName: PALLAVI
MiddleName: P
NamePrefix: MS.
NameSuffix:  
Credential: PT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 39 MILLBANK LN
Address2:  
City: VOORHEES
State: NJ
PostalCode: 080432548
CountryCode: US
TelephoneNumber: 8567511600
FaxNumber:  
Practice Location
Address1: 3001 E EVESHAM RD
Address2:  
City: VOORHEES
State: NJ
PostalCode: 080439547
CountryCode: US
TelephoneNumber: 8567511600
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/23/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XQA01145100NJY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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