Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 31006920A | IN |
N | 225XH1200X | Occupational Therapist - Hand | 31006920A | IN |
NPI | 1154072353 |
---|---|
Provider Name | Joseph Sharaya |
First Address | Indianapolis, IN 46241-4348 |
Second Address | Indianapolis, IN 46241-4348 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2022 |
Last Update Date | 10/01/2022 |