Healthcare Provider Details

I. General information

NPI: 1750075008
Provider Name (Legal Business Name): HARSHAL SHAH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2023
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 BOXWOOD WAY
WARREN NJ
07059-6859
US

IV. Provider business mailing address

5 BOXWOOD WAY
WARREN NJ
07059-6859
US

V. Phone/Fax

Practice location:
  • Phone: 201-936-7048
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number46TR01310400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: