Provider Demographics
NPI:1679025548
Name:BABU, BOBEN (PT, DPT)
Entity type:Individual
Prefix:
First Name:BOBEN
Middle Name:
Last Name:BABU
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:158 FISHER RD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-4143
Mailing Address - Country:US
Mailing Address - Phone:215-704-1356
Mailing Address - Fax:267-382-0088
Practice Address - Street 1:723 ROUTE 113
Practice Address - Street 2:#6
Practice Address - City:SOUDERTON
Practice Address - State:PA
Practice Address - Zip Code:18964-1000
Practice Address - Country:US
Practice Address - Phone:215-538-1999
Practice Address - Fax:267-382-0088
Is Sole Proprietor?:No
Enumeration Date:2016-10-26
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT0253002251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic