Revathy Kalyan

Primary specialty

Geriatric Physical TherapistTaxonomy code 2251G0304X

License

5501010750 Issued in MI

Practice address

41255 Pond View Dr
Sterling Heights, MI 48314-3847

Phone

(248) 495-3542

NPI assigned

Oct 17, 2014

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Revathy Devaraj Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1413504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413504000000",
    "number": "1508260670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1926 CRIMSON DR",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480835544",
            "telephone_number": "248-495-3542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41255 POND VIEW DR",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483143847",
            "telephone_number": "248-495-3542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALYAN",
        "first_name": "REVATHY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-17",
        "last_updated": "2014-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "MI",
            "license": "5501010750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REVATHY",
            "last_name": "DEVARAJ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Puneet Kalkat, OD
• Melody Haikal Kalla, RPH
• Stacey Kallenbach
• Jasleen Aulakh Kalsi
• Selma Kaltak
• Samia Kamal
• Sarah Jean Kanaby, LMSW
• David Christian Kang, DAOM
• Jun Kang, PH.D.
• Jeffrey Ryan Kangas, M.D.

• Geriatric Physical Therapist in Sterling Heights, MI
• Providers in Sterling Heights, MI by specialty
• Geriatric Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.