Provider Demographics
NPI:1336509058
Name:CHOKSHI, SHIPRA
Entity Type:Individual
Prefix:
First Name:SHIPRA
Middle Name:
Last Name:CHOKSHI
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 1:214 MONROE AVE
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-3719
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8635 QUEENS BLVD
Practice Address - Street 2:SUITE 1B
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-4434
Practice Address - Country:US
Practice Address - Phone:212-671-0978
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-24
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034942-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist