Provider Demographics
NPI:1386038743
Name:SHAH, POOJA (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:POOJA
Middle Name:
Last Name:SHAH
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3535 QUAKERBRIDGE RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-1200
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3535 QUAKERBRIDGE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-1200
Practice Address - Country:US
Practice Address - Phone:609-890-9195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-24
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01600200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist