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Individual

SHIRISH R GODBOLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OTR CHT

Contact information

Practice address
40 ROUTE 34, SUITE F PROFESSIONAL BLDG, OLD BRIDGE, NJ 08857
(732) 727-7333
(732) 727-7333
Mailing address
40 ROUTE 34, SUITE F PROFESSIONAL BLDG, OLD BRIDGE, NJ 08857
(732) 727-7333
(732) 727-7333

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
TR001614
NJ
225XH1200X
Hand Occupational Therapist
Primary
9511000027
NJ

Other

Enumeration date
04/03/2007
Last updated
09/13/2012
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