NPI Code Details Logo

NPI 1619861861

NPI 1619861861 : SHALU YADAV PT : QUINCY, MA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1619861861
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    SHALU YADAV PT
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    06/04/2025
-----------------------------------------------------
    Last Update Date     |    06/04/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    2300 CROWN COLONY DR STE 102 
-----------------------------------------------------
    City                 |    QUINCY
-----------------------------------------------------
    State                |    MA
-----------------------------------------------------
    Zip                  |    02169-0902
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    781-986-0990
-----------------------------------------------------
    Fax                  |    781-986-0991
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    4 RICHMOND SQ STE 200 
-----------------------------------------------------
    City                 |    PROVIDENCE
-----------------------------------------------------
    State                |    RI
-----------------------------------------------------
    Zip                  |    02906-5117
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    401-726-7100
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    225100000X
-----------------------------------------------------
    Taxonomy Name        |    Physical Therapist
-----------------------------------------------------
    License Number       |    PTL88464
-----------------------------------------------------
    License Number State |    MA
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.