Basic Information
Provider Information
NPI: 1295473510
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HARIHARAN
FirstName: SWETHA
MiddleName:  
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Credential:  
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Mailing Information
Address1: 7 DIGITAL DR UNIT 105
Address2:  
City: NASHUA
State: NH
PostalCode: 030624493
CountryCode: US
TelephoneNumber: 7817801638
FaxNumber:  
Practice Location
Address1: 2701 CHESTNUT STATION CT
Address2:  
City: LOUISVILLE
State: KY
PostalCode: 402996395
CountryCode: US
TelephoneNumber: 8003351060
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/25/2022
LastUpdateDate: 05/25/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: Y
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AuthorizedOfficialCredential:  
NPICertificationDate: 05/25/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225200000X9632MAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant 

No ID Information.


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