Healthcare Provider Details

I. General information

NPI: 1174750442
Provider Name (Legal Business Name): DR. SHEETAL RASHMIKANT JOSHI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2009
Last Update Date: 08/08/2022
Certification Date: 08/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 C CT
ASHTABULA OH
44004-4577
US

IV. Provider business mailing address

500 N MAIN ST STE 620
ROSWELL NM
88201-4767
US

V. Phone/Fax

Practice location:
  • Phone: 440-998-4210
  • Fax:
Mailing address:
  • Phone: 808-909-2003
  • Fax: 808-909-2004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number35093340
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number35093340
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number35093340
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number35093340
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: