Provider Demographics
NPI:1962525238
Name:SHAH, RINABEN R (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:RINABEN
Middle Name:R
Last Name:SHAH
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 WILDERNESS RUN CT
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-4737
Mailing Address - Country:US
Mailing Address - Phone:732-586-9558
Mailing Address - Fax:
Practice Address - Street 1:3 WILDERNESS RUN CT
Practice Address - Street 2:
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-4737
Practice Address - Country:US
Practice Address - Phone:732-586-9558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01033300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist