Provider Demographics
NPI:1689413213
Name:PRABHAKARAN-NAIR, SREEJESH (DPT)
Entity type:Individual
Prefix:DR
First Name:SREEJESH
Middle Name:
Last Name:PRABHAKARAN-NAIR
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2010 STRATTON HILLS CT
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-2571
Mailing Address - Country:US
Mailing Address - Phone:336-509-9616
Mailing Address - Fax:
Practice Address - Street 1:2010 STRATTON HILLS CT
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-2571
Practice Address - Country:US
Practice Address - Phone:336-509-9616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-22
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC000031165667225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist