Provider Demographics
NPI:1588752182
Name:JOBANPUTRA, SHEFALI MANHAR (DC)
Entity type:Individual
Prefix:DR
First Name:SHEFALI
Middle Name:MANHAR
Last Name:JOBANPUTRA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 JUNE LN
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02459-3643
Mailing Address - Country:US
Mailing Address - Phone:610-252-1952
Mailing Address - Fax:
Practice Address - Street 1:1194 WALNUT ST
Practice Address - Street 2:STE 205
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02461-1269
Practice Address - Country:US
Practice Address - Phone:609-540-2224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2016-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00588000111N00000X
MA3342111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ055754Medicare PIN
NJU89174Medicare UPIN