Provider Demographics
NPI:1235237397
Name:SHUKLA, HERSH A (MPT)
Entity Type:Individual
Prefix:MR
First Name:HERSH
Middle Name:A
Last Name:SHUKLA
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:850 WALNUT BOTTOM RD
Mailing Address - Street 2:SUITE 306
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17013-3632
Mailing Address - Country:US
Mailing Address - Phone:717-241-2211
Mailing Address - Fax:717-241-2240
Practice Address - Street 1:97 PROGRESS BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:SHIPPENSBURG
Practice Address - State:PA
Practice Address - Zip Code:17257-9595
Practice Address - Country:US
Practice Address - Phone:717-477-2066
Practice Address - Fax:717-477-2070
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2009-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT012801L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA038890THJMedicare ID - Type Unspecified