Provider Demographics
NPI:1003003088
Name:VORA-SHAH, AVANI R (MPT, DPT)
Entity Type:Individual
Prefix:
First Name:AVANI
Middle Name:R
Last Name:VORA-SHAH
Suffix:
Gender:F
Credentials:MPT, DPT
Other - Prefix:
Other - First Name:AVANI
Other - Middle Name:R
Other - Last Name:VORA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT, DPT
Mailing Address - Street 1:3228 STATE ROUTE 27
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:KENDALL PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08824-1524
Mailing Address - Country:US
Mailing Address - Phone:732-297-0032
Mailing Address - Fax:
Practice Address - Street 1:3228 STATE ROUTE 27
Practice Address - Street 2:SUITE 2A
Practice Address - City:KENDALL PARK
Practice Address - State:NJ
Practice Address - Zip Code:08824-1524
Practice Address - Country:US
Practice Address - Phone:732-297-0032
Practice Address - Fax:732-297-0558
Is Sole Proprietor?:No
Enumeration Date:2007-10-03
Last Update Date:2019-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01254500225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist