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1740306455 NPI number — DHRUTI JAGDISH SHAH R.P.T

NPI Number: 1740306455
Health Care Provider/Practitioner: DHRUTI JAGDISH SHAH R.P.T

Information about “1740306455” NPI (DHRUTI JAGDISH SHAH R.P.T) exists in 1740306455 in HTML format HTML  |  1740306455 in plain Text format TXT  |  1740306455 in PDF (Portable Document Format) PDF  |  1740306455 in an XML format XML  formats.

NPI Number : 1740306455 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1740306455",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "SHAH",
    "FirstName": "DHRUTI",
    "MiddleName": "JAGDISH",
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "R.P.T",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "3565 SEQUOIA CMN",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "FREMONT",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "94536-5782",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "510-790-0383",
    "MailingAddressFaxNumber": "510-790-1197",
    "FirstLinePracticeLocationAddress": "1895 MOWRY AVE",
    "SecondLinePracticeLocationAddress": "STE. 118-A",
    "PracticeLocationAddressCityName": "FREMONT",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "94538-1737",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "510-790-0383",
    "PracticeLocationAddressFaxNumber": "510-790-1197",
    "EnumerationDate": "03/22/2007",
    "LastUpdateDate": "07/08/2007",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "225100000X",
        "TaxonomyName": "Physical Therapist",
        "LicenseNumber": "PT28501",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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