Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | 25MA06499000 | NJ |
NPI | 1003880329 |
---|---|
Provider Name | Ashish Shah |
First Address | Newark, NJ 07189-0001 |
Second Address | Morristown, NJ 07960-6136 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2006 |
Last Update Date | 17/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F42901 | (02) | NJ |