Provider Demographics
NPI:1225469638
Name:SHEK, RAYMOND (DPT)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:
Last Name:SHEK
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2068 PRINCETON AVE
Mailing Address - Street 2:
Mailing Address - City:FANWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07023-1717
Mailing Address - Country:US
Mailing Address - Phone:908-370-7918
Mailing Address - Fax:
Practice Address - Street 1:2068 PRINCETON AVE
Practice Address - Street 2:
Practice Address - City:FANWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07023-1717
Practice Address - Country:US
Practice Address - Phone:908-370-7918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-10
Last Update Date:2013-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY037033225100000X
VA2305208449225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist