Provider Demographics
NPI:1326210436
Name:SHETH, PRAGNA (PT)
Entity Type:Individual
Prefix:MRS
First Name:PRAGNA
Middle Name:
Last Name:SHETH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MRS
Other - First Name:PRAGNA
Other - Middle Name:
Other - Last Name:SHETH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:27 JUNCTION POND LN
Mailing Address - Street 2:
Mailing Address - City:MONMOUTH JUNCTION
Mailing Address - State:NJ
Mailing Address - Zip Code:08852-2924
Mailing Address - Country:US
Mailing Address - Phone:732-329-0410
Mailing Address - Fax:
Practice Address - Street 1:3910 PARK AVE
Practice Address - Street 2:IRI REHAB STAFF
Practice Address - City:EDITION
Practice Address - State:NJ
Practice Address - Zip Code:08820
Practice Address - Country:US
Practice Address - Phone:732-549-2030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-28
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00121900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist