Provider Demographics
NPI:1407498223
Name:SHENOY, SHWETA SITARAM (PT)
Entity Type:Individual
Prefix:MISS
First Name:SHWETA SITARAM
Middle Name:
Last Name:SHENOY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 HOPKINS AVENUE
Mailing Address - Street 2:
Mailing Address - City:JERSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306
Mailing Address - Country:US
Mailing Address - Phone:551-358-6486
Mailing Address - Fax:
Practice Address - Street 1:208 HOPKINS AVENUE 2ND FLOOR
Practice Address - Street 2:
Practice Address - City:JERSEY
Practice Address - State:NJ
Practice Address - Zip Code:07306
Practice Address - Country:US
Practice Address - Phone:718-434-4311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-14
Last Update Date:2019-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0449722251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic