Provider Demographics
NPI:1841675147
Name:SHAH, RUCHI PARUL (MS, DPT,OCS,CMP)
Entity type:Individual
Prefix:
First Name:RUCHI
Middle Name:PARUL
Last Name:SHAH
Suffix:
Gender:F
Credentials:MS, DPT,OCS,CMP
Other - Prefix:
Other - First Name:RUCHITA
Other - Middle Name:BRIJESH
Other - Last Name:PARIKH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:133 W HUNTING PARK AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19140-2717
Mailing Address - Country:US
Mailing Address - Phone:215-455-5370
Mailing Address - Fax:215-455-5374
Practice Address - Street 1:233 E KING ST STE 103
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:PA
Practice Address - Zip Code:19355-2574
Practice Address - Country:US
Practice Address - Phone:914-294-4050
Practice Address - Fax:215-455-5374
Is Sole Proprietor?:No
Enumeration Date:2015-07-28
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25364225100000X
PA0256862251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist