Provider Demographics
NPI:1316454523
Name:SHETH, JALPA KAUSHAL
Entity type:Individual
Prefix:
First Name:JALPA
Middle Name:KAUSHAL
Last Name:SHETH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JALPA
Other - Middle Name:JAYKUMAR
Other - Last Name:PAREKH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:178 COLUMBIA AVE
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07307-4019
Mailing Address - Country:US
Mailing Address - Phone:201-744-0542
Mailing Address - Fax:
Practice Address - Street 1:178 COLUMBIA AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07307-4019
Practice Address - Country:US
Practice Address - Phone:201-744-0542
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-09
Last Update Date:2018-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ86039561133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered