Provider Demographics
NPI:1073091385
Name:SHAH, SHEFALI K (OTR/L)
Entity Type:Individual
Prefix:MISS
First Name:SHEFALI
Middle Name:K
Last Name:SHAH
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1506 TIMBER OAKS RD
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-1550
Mailing Address - Country:US
Mailing Address - Phone:732-213-4535
Mailing Address - Fax:
Practice Address - Street 1:1506 TIMBER OAKS RD
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-1550
Practice Address - Country:US
Practice Address - Phone:732-213-4535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-30
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022718225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist