Provider Demographics
NPI:1083397145
Name:ANKITA SHUKLA PHYSICAL THERAPY INC.
Entity Type:Organization
Organization Name:ANKITA SHUKLA PHYSICAL THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANKITA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHUKLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-330-1285
Mailing Address - Street 1:4077 FENNEL TER
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-4094
Mailing Address - Country:US
Mailing Address - Phone:734-330-1285
Mailing Address - Fax:
Practice Address - Street 1:4077 FENNEL TER
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-4094
Practice Address - Country:US
Practice Address - Phone:734-330-1285
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy