Provider Demographics
NPI:1154188209
Name:SHUKLA, TOESHA MANISHKUMAR (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:TOESHA
Middle Name:MANISHKUMAR
Last Name:SHUKLA
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7002 JFK BOULEVARD EAST
Mailing Address - Street 2:APT #43 D
Mailing Address - City:GUTTENBERG
Mailing Address - State:NJ
Mailing Address - Zip Code:07093
Mailing Address - Country:US
Mailing Address - Phone:917-913-6007
Mailing Address - Fax:
Practice Address - Street 1:138TH ST BRONX
Practice Address - Street 2:255 EAST
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10451
Practice Address - Country:US
Practice Address - Phone:718-559-0909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-05
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY051643-01225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist