Provider Demographics
NPI:1649403270
Name:SHAH, SWEETY (BPT)
Entity type:Individual
Prefix:
First Name:SWEETY
Middle Name:
Last Name:SHAH
Suffix:
Gender:F
Credentials:BPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:39120 ARGONAUT WAY
Mailing Address - Street 2:SUITE 274
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1304
Mailing Address - Country:US
Mailing Address - Phone:661-663-8083
Mailing Address - Fax:510-279-5657
Practice Address - Street 1:555 MOWRY AVE
Practice Address - Street 2:SUITE E
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94536-4101
Practice Address - Country:US
Practice Address - Phone:510-745-7700
Practice Address - Fax:510-279-5657
Is Sole Proprietor?:No
Enumeration Date:2009-08-31
Last Update Date:2009-10-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA35928225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist