Provider Demographics
NPI:1275835431
Name:SHASTRI, HEMANGI DEEPAK
Entity Type:Individual
Prefix:MRS
First Name:HEMANGI
Middle Name:DEEPAK
Last Name:SHASTRI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 ASHFORD DR
Mailing Address - Street 2:
Mailing Address - City:PLAINSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08536-3632
Mailing Address - Country:US
Mailing Address - Phone:609-799-7248
Mailing Address - Fax:
Practice Address - Street 1:2650 ROUTE 130
Practice Address - Street 2:SUITE C
Practice Address - City:CRANBURY
Practice Address - State:NJ
Practice Address - Zip Code:08512-3327
Practice Address - Country:US
Practice Address - Phone:609-655-4586
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-22
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA005743002251H1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251H1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistHand