Basic Information
| Provider Information | |||||||||
| NPI: | 1124142302 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | REPATACODO-ALMASRI | ||||||||
| FirstName: | APRIL | ||||||||
| MiddleName: | |||||||||
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| Credential: | RPT | ||||||||
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| OtherLastName: | REPATACODO | ||||||||
| OtherFirstName: | APRIL | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 11412 BAYHILL WAY | ||||||||
| Address2: | |||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462369235 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3172608476 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 5980 W 71ST ST STE 201 | ||||||||
| Address2: | |||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462781785 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3173880800 | ||||||||
| FaxNumber: | 3173880805 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/16/2007 | ||||||||
| LastUpdateDate: | 07/30/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/30/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 050008918A | IN | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 171W00000X | 027876 | NY | Y | Other Service Providers | Contractor |
No ID Information.