Provider Demographics
NPI:1649446949
Name:SHETH, NALINI K (BS)
Entity type:Individual
Prefix:
First Name:NALINI
Middle Name:K
Last Name:SHETH
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:257 CORNWELL AVE
Mailing Address - Street 2:
Mailing Address - City:WILLISTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11596-1047
Mailing Address - Country:US
Mailing Address - Phone:516-294-6126
Mailing Address - Fax:
Practice Address - Street 1:257 CORNWELL AVE
Practice Address - Street 2:
Practice Address - City:WILLISTON PARK
Practice Address - State:NY
Practice Address - Zip Code:11596-1047
Practice Address - Country:US
Practice Address - Phone:516-294-6126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-06
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020046-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY020046-1Medicaid
NY020046-1Medicaid