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NPI Code Detail

MEDICARE: MR. RUCHIR SHAH MS OTR/L

MEDICARE: MR. RUCHIR SHAH MS OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist019343NY

General Provider Information

NPI Number : 1366839722
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RUCHIR SHAH MS OTR/L
Provider Business Mailing Address
First Line : 22 STEVEN DR
Second Line :
City : HEWLETT
State : NY
Zip : 11557-1009
Country : US
Telephone Number : 516-302-5076
Fax Number :
Provider Business Practice Location Address
First Line : 274 W BROADWAY
Second Line :
City : LONG BEACH
State : NY
Zip : 11561-3911
Country : US
Telephone Number : 516-431-1400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/22/2015
Last Update Date : 04/22/2015

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