Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 40QA01254500 | NJ |
NPI | 1003003088 |
---|---|
Provider Name | Avani R Vora-Shah |
First Address | Kendall Park, NJ 08824-1524 |
Second Address | Kendall Park, NJ 08824-1524 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2007 |
Last Update Date | 30/09/2019 |