Basic Information
| Provider Information | |||||||||
| NPI: | 1407498223 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SHENOY | ||||||||
| FirstName: | SHWETA SITARAM | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MISS | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 208 HOPKINS AVENUE | ||||||||
| Address2: | |||||||||
| City: | JERSEY | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07306 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5513586486 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 208 HOPKINS AVENUE 2ND FLOOR | ||||||||
| Address2: | |||||||||
| City: | JERSEY | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07306 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7184344311 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/14/2019 | ||||||||
| LastUpdateDate: | 10/14/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2251X0800X | 044972 | NY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic |
No ID Information.