MEDICARE: SEJAL SHAH KINKER OT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	0119002806	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	194769	OTHER	VA	ANTHEM
2	540885859	OTHER	VA	MULTIPLAN
3	540885859	OTHER	VA	FIRST HEALTH/CCN
4	1184063	OTHER	VA	AETNA HMO
5	540885859	OTHER	VA	FOCUS
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	258462	OTHER	VA	SOUTHERN HEALTH
8	540885859	OTHER	VA	PHCS
9	540885859	OTHER	VA	CIGNA REHAB PROVIDER
10	OPTIMA HEALTH	OTHER	VA	98999

General Provider Information

NPI Number	:	1578529616
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SEJAL SHAH KINKER OT

Provider Business Mailing Address
First Line	:	7858 SHRADER RD
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23294-4222
Country	:	US
Telephone Number	:	804-270-1305
Fax Number	:	804-273-9294

Provider Business Practice Location Address
First Line	:	7858 SHRADER RD
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23294-4222
Country	:	US
Telephone Number	:	804-270-1305
Fax Number	:	804-273-9294

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/26/2006
Last Update Date	:	01/12/2012

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Directions to “ SEJAL SHAH KINKER OT” Practice Location

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