Provider Demographics
NPI:1578183083
Name:BAJARIA, SHWETA ((PT, DPT))
Entity Type:Individual
Prefix:
First Name:SHWETA
Middle Name:
Last Name:BAJARIA
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 1:1150 PARK AVE STE 1D
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-1244
Mailing Address - Country:US
Mailing Address - Phone:212-594-0471
Mailing Address - Fax:646-647-8070
Practice Address - Street 1:1150 PARK AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-1244
Practice Address - Country:US
Practice Address - Phone:951-427-0764
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-24
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044507225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist