Provider Demographics
NPI:1568596419
Name:SHAH, PRITI SANGHVI (OT)
Entity Type:Individual
Prefix:
First Name:PRITI
Middle Name:SANGHVI
Last Name:SHAH
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:SANGHVI
Other - Middle Name:PRITI
Other - Last Name:SUBHODHCHANDRA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1211 HAMBURG TPKE STE 306
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-5056
Mailing Address - Country:US
Mailing Address - Phone:973-706-8270
Mailing Address - Fax:973-706-8272
Practice Address - Street 1:1211 HAMBURG TPKE STE 306
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-5056
Practice Address - Country:US
Practice Address - Phone:973-706-8270
Practice Address - Fax:973-706-8272
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2010-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist