Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 101484 | NY |
N | 111N00000X | Chiropractor | 38MC00603700 | NJ |
N | 111NN0400X | Neurology | 010484 | NY |
N | 111NR0400X | Rehabilitation Chiropractor | 010484 | NY |
NPI | 1700899259 |
---|---|
Provider Name | Ayaz A Shah |
First Address | Bordentown, NJ 08505-4448 |
Second Address | Jackson Heights, NY 11372-7631 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2006 |
Last Update Date | 31/12/2007 |