Provider Demographics
NPI:1275115198
Name:SHANTI REHAB SERVICES, LLC
Entity Type:Organization
Organization Name:SHANTI REHAB SERVICES, LLC
Other - Org Name:SHANTI PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PT DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JALDIP
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-702-3888
Mailing Address - Street 1:71 FOUNTAYNE LN
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-2679
Mailing Address - Country:US
Mailing Address - Phone:609-912-4477
Mailing Address - Fax:609-642-4227
Practice Address - Street 1:897 US HIGHWAY 130
Practice Address - Street 2:
Practice Address - City:EAST WINDSOR
Practice Address - State:NJ
Practice Address - Zip Code:08520-2907
Practice Address - Country:US
Practice Address - Phone:313-702-3888
Practice Address - Fax:609-642-4227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-21
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy