Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | 283269 | NY |
NPI | 1053654822 |
---|---|
Provider Name | Ami J Shah |
First Address | Bronx, NY 10467-2401 |
Second Address | New York, NY 10016-4901 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2013 |
Last Update Date | 29/03/2021 |