Provider Demographics
NPI:1518088657
Name:SHENOY, SHOBANA R (OTR-L)
Entity Type:Individual
Prefix:MS
First Name:SHOBANA
Middle Name:R
Last Name:SHENOY
Suffix:
Gender:F
Credentials:OTR-L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 NORBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-6119
Mailing Address - Country:US
Mailing Address - Phone:301-379-2877
Mailing Address - Fax:
Practice Address - Street 1:17 NORBRIDGE DR
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-6119
Practice Address - Country:US
Practice Address - Phone:301-379-2877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00537300225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist