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General NPI Number Information
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NPI Number | 1720360282
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Entity Type | Individual
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Provider Name | JINAL DEEPAK SHAH P.T.
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Gender | Female
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Dates
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Enumeration Date | 09/12/2011
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 3263 PROFFIT RD STE 203
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22911-5639
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Country | US
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Telephone | 434-220-0021
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Fax | 434-465-6843
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Provider Business Mailing Address
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Address Line | 504 ALBEMARLE SQ
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22901-7405
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Country | US
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Telephone | 434-817-7848
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5501015185
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2305216347
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License Number State | VA
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