Provider Demographics
NPI:1467863225
Name:SHETH, TRUSHITA (PT)
Entity Type:Individual
Prefix:MRS
First Name:TRUSHITA
Middle Name:
Last Name:SHETH
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 1:20846 MEDIX RUN PL
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-2846
Mailing Address - Country:US
Mailing Address - Phone:703-581-4108
Mailing Address - Fax:
Practice Address - Street 1:8315 TURNING LEAF LN
Practice Address - Street 2:
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22102-2615
Practice Address - Country:US
Practice Address - Phone:703-734-1600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-14
Last Update Date:2020-03-11
Deactivation Date:2020-02-20
Deactivation Code:
Reactivation Date:2020-03-11
Provider Licenses
StateLicense IDTaxonomies
VA2305207964225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist