Provider Demographics
NPI:1255567129
Name:SHEIKH, RUBAB TAHIRA (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:RUBAB
Middle Name:TAHIRA
Last Name:SHEIKH
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 FIRESTONE DR
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-5046
Mailing Address - Country:US
Mailing Address - Phone:732-475-9163
Mailing Address - Fax:732-367-0060
Practice Address - Street 1:399 ALBERT AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-5406
Practice Address - Country:US
Practice Address - Phone:732-367-0060
Practice Address - Fax:732-357-0060
Is Sole Proprietor?:No
Enumeration Date:2009-06-05
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00937400225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ084636Medicare PIN