MEDICARE: MS. GAURI S SHETYE

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	043091	NY

General Provider Information

NPI Number	:	1952661787
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. GAURI S SHETYE

Provider Business Mailing Address
First Line	:	8614 143RD ST
Second Line	:
City	:	BRIARWOOD
State	:	NY
Zip	:	11435-3020
Country	:	US
Telephone Number	:	909-289-5384
Fax Number	:

Provider Business Practice Location Address
First Line	:	2419 85TH ST FL 2
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214-3503
Country	:	US
Telephone Number	:	646-577-1054
Fax Number	:

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

Provider Enumeration Date	:	05/27/2012
Last Update Date	:	05/27/2012

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Directions to “ MS. GAURI S SHETYE ” Practice Location

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