Provider Demographics
NPI:1750835351
Name:SHETH, BHAVIK (PT, DPT)
Entity Type:Individual
Prefix:
First Name:BHAVIK
Middle Name:
Last Name:SHETH
Suffix:
Gender:M
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 1:6155 98TH ST APT 16H
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-1439
Mailing Address - Country:US
Mailing Address - Phone:718-308-5225
Mailing Address - Fax:
Practice Address - Street 1:10615 QUEENS BLVD # B11
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4301
Practice Address - Country:US
Practice Address - Phone:646-389-1161
Practice Address - Fax:201-591-7839
Is Sole Proprietor?:No
Enumeration Date:2016-08-11
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01999900225100000X
CA297922225100000X
NY040351225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist