Healthcare Provider Details

I. General information

NPI: 1992224877
Provider Name (Legal Business Name): AKSHI SHAH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2017
Last Update Date: 09/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

171 E 84TH ST FL 2
NEW YORK NY
10028-2029
US

IV. Provider business mailing address

19 MEADOW BROOK RD
EDISON NJ
08837-2003
US

V. Phone/Fax

Practice location:
  • Phone: 212-327-0600
  • Fax: 212-327-0776
Mailing address:
  • Phone: 904-412-9691
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number041628-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: