Provider Demographics
NPI:1104248350
Name:SHAH, NEAL (DPT)
Entity type:Individual
Prefix:
First Name:NEAL
Middle Name:
Last Name:SHAH
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 COOGAN CT
Mailing Address - Street 2:
Mailing Address - City:MORRIS PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07950-2553
Mailing Address - Country:US
Mailing Address - Phone:973-634-3966
Mailing Address - Fax:
Practice Address - Street 1:15 COOGAN CT
Practice Address - Street 2:
Practice Address - City:MORRIS PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07950-2553
Practice Address - Country:US
Practice Address - Phone:973-634-3966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-07
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT009978225100000X
NJ40QA01655200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist