Provider Demographics
NPI:1295347565
Name:SHAH REHABILITATION GROUP LLC
Entity type:Organization
Organization Name:SHAH REHABILITATION GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SHOUNAK
Authorized Official - Middle Name:G
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:201-893-7424
Mailing Address - Street 1:1115 GRAND ST APT 5B
Mailing Address - Street 2:
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-2260
Mailing Address - Country:US
Mailing Address - Phone:201-893-7424
Mailing Address - Fax:
Practice Address - Street 1:1115 GRAND ST APT 5B
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-2260
Practice Address - Country:US
Practice Address - Phone:201-893-7424
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-18
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy