| Doctor Name: | VIDISHA SHAH |
| NPI Number: | 1003152265 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MPT |
| License Number: | 035781 |
| Business Practice Address: | 525 Neptune Avenue Lobby Brooklyn, NY - 11224 |
| Business Phone Number: | 7185130295 |
| Business Fax Number: | |
| Mailing Address: | 8614 143rd St, BRIARWOOD |
| State: | NY |
| Postal Code: | 11435 |
| Phone Number: | 6262023596 |
| Fax Number: | |
| NPI Enumeration Date: | 12/17/2012 |
| NPI Last Update Date: | 03/26/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 035781 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |