Provider Demographics
NPI:1053545103
Name:SHANKAR, NIRUPAMA (PT)
Entity type:Individual
Prefix:MS
First Name:NIRUPAMA
Middle Name:
Last Name:SHANKAR
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 AMIABLE LOOP
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-5566
Mailing Address - Country:US
Mailing Address - Phone:919-267-6825
Mailing Address - Fax:
Practice Address - Street 1:120 AMIABLE LOOP
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27519-5566
Practice Address - Country:US
Practice Address - Phone:919-267-6825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-04
Last Update Date:2009-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPT87087225100000X
MI5501011895225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist