National Provider Identifier

Jill Shah, PT, DPT

Jill Shah, PT, DPT is listed in the NPPES registry with a primary specialty of Physical Therapist in Ithaca, NY and a listed phone number of (607) 274-4159.

NPI 1821681503Ithaca, NYPhysical Therapist

Profile Overview

NPI
1821681503
Provider Type
Individual
Primary Specialty
Physical Therapist
Enumeration Date
February 15, 2021
Last Updated
February 15, 2021

Practice Location

  • 10 Brentwood Dr
  • Ithaca, NY 14850-1865

Phone: (607) 274-4159

Mailing Address

  • 10 Brentwood Dr Ste A
  • Ithaca, NY 14850-1866

Specialties

  • Physical Therapist (225100000X)
Full Record
NPI
1821681503
Entity Type
Individual
Last Name
Shah
First Name
Jill
Credential
PT, DPT
Mailing Street Address
10 Brentwood Dr Ste A
Mailing City
Ithaca
Mailing State
NY
Mailing ZIP Code
14850-1866
Mailing Country
US
Mailing Phone
(607) 274-4159
Practice Street Address
10 Brentwood Dr
Practice City
Ithaca
Practice State
NY
Practice ZIP Code
14850-1865
Practice Country
US
Practice Phone
(607) 274-4159
Enumeration Date
February 15, 2021
Last Updated
February 15, 2021
Sex
Female
Sole Proprietor
Yes
Taxonomy Group 1
193400000X Single Specialty Group
Certification Date
February 12, 2021
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Physical Therapist (225100000X)