Healthcare Provider Details

I. General information

NPI: 1912860958
Provider Name (Legal Business Name): KONNECT THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2025
Last Update Date: 12/06/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 MIDDLESEX TPKE STE 208
ISELIN NJ
08830-2033
US

IV. Provider business mailing address

200 MIDDLESEX TPKE STE 208
ISELIN NJ
08830-2033
US

V. Phone/Fax

Practice location:
  • Phone: 732-924-7350
  • Fax: 732-924-7351
Mailing address:
  • Phone: 732-924-7350
  • Fax: 732-924-7351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State

VIII. Authorized Official

Name: KHUSHBU SHAH
Title or Position: FOUNDER
Credential: MD
Phone: 732-924-7350