Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 046942 | NY |
N | 2251N0400X | Physical Therapist - Neurology | 046942 | NY |
N | 2251X0800X | Physical Therapist - Orthopedic | 046942 | NY |
NPI | 1578146999 |
---|---|
Provider Name | Mrs. Pooja D Shah |
First Address | Branchburg, NJ 08853-4283 |
Second Address | Branchburg, NJ 08853-4283 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2021 |
Last Update Date | 03/05/2021 |