Shivani Mehta, DPT

Individual provider Active NPI Physical Therapist · Medina, NY

NPI 1821340787 · NPPES record last updated Oct 2, 2012

Key facts

NPI
1821340787
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
031553-1 (NY)
Practice address
418 State St
Medina, NY 14103-9701
Phone
(585) 314-8777
NPI assigned
Oct 2, 2012
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
031553-1NYMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 031553-1 NY Yes

Addresses

Primary practice location

418 State St
Medina, NY 14103-9701

Mailing address

418 State St
Medina, NY 14103-9701
Phone (585) 314-8777

Other providers in Medina, NY

All providers in Medina, NY · Physical Therapist in New York

Sources for this page

Verify at the official NPI Registry.