MEDICARE: BHAKTI SHAH

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
1	225100000X	Physical Therapist	034674	NY

General Provider Information

NPI Number	:	1538585716
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BHAKTI SHAH

Provider Business Mailing Address
First Line	:	2 OLD MAMARONECK RD APT 7A
Second Line	:
City	:	WHITE PLAINS
State	:	NY
Zip	:	10605-1726
Country	:	US
Telephone Number	:	847-736-2994
Fax Number	:

Provider Business Practice Location Address
First Line	:	3755 HENRY HUDSON PKWY
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10463-1535
Country	:	US
Telephone Number	:	917-209-6335
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/11/2014
Last Update Date	:	03/11/2014

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Directions to “ BHAKTI SHAH ” Practice Location

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