Provider Demographics
NPI:1891759072
Name:SHAH, ANILKUMAR L (RPT)
Entity Type:Individual
Prefix:MR
First Name:ANILKUMAR
Middle Name:L
Last Name:SHAH
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:44 HINTON ST
Mailing Address - Street 2:
Mailing Address - City:SAYREVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08872-1088
Mailing Address - Country:US
Mailing Address - Phone:732-238-8941
Mailing Address - Fax:732-238-8979
Practice Address - Street 1:3 PARLIN DR
Practice Address - Street 2:SUITE H
Practice Address - City:PARLIN
Practice Address - State:NJ
Practice Address - Zip Code:08859-2263
Practice Address - Country:US
Practice Address - Phone:732-238-8151
Practice Address - Fax:732-238-8979
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00626100225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist