Provider Demographics
NPI:1881330157
Name:AKHTER, SHAKILA (OT)
Entity type:Individual
Prefix:
First Name:SHAKILA
Middle Name:
Last Name:AKHTER
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:543 N TRENTON AVE
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08401-1346
Mailing Address - Country:US
Mailing Address - Phone:609-233-7609
Mailing Address - Fax:
Practice Address - Street 1:108 WOODWARD RD
Practice Address - Street 2:
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-4223
Practice Address - Country:US
Practice Address - Phone:855-678-8887
Practice Address - Fax:855-678-8887
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-10
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR01057200225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist