Basic Information
| Provider Information | |||||||||
| NPI: | 1346585668 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GOVINDU | ||||||||
| FirstName: | RAJEWENI | ||||||||
| MiddleName: | KUMAR | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | OTR | ||||||||
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| Mailing Information | |||||||||
| Address1: | 200 NORTHPOINTE CIR STE 200 | ||||||||
| Address2: | |||||||||
| City: | SEVEN FIELDS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 160467861 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 520 KERR AVE | ||||||||
| Address2: | |||||||||
| City: | DENTON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 216291343 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4104792130 | ||||||||
| FaxNumber: | 4104790396 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/28/2012 | ||||||||
| LastUpdateDate: | 11/28/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 05758 | MD | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.