Provider Demographics
NPI:1396821088
Name:SHAH, DIPTI V (RPT)
Entity type:Individual
Prefix:MRS
First Name:DIPTI
Middle Name:V
Last Name:SHAH
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
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Mailing Address - Street 1:401 ANDOVER ST STE 101
Mailing Address - Street 2:
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-5076
Mailing Address - Country:US
Mailing Address - Phone:978-746-5295
Mailing Address - Fax:978-824-9335
Practice Address - Street 1:401 ANDOVER ST STE 101
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-5076
Practice Address - Country:US
Practice Address - Phone:978-746-5295
Practice Address - Fax:978-824-9335
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2025-08-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MAMA8213225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0365041Medicaid
MA0365041Medicaid