Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 221447 | NY |
N | 111NI0900X | Internist | 221447 | NY |
Y | 207RH0003X | Hematology & Oncology | 25MA06728200 | NJ |
NPI | 1053345629 |
---|---|
Provider Name | Chirag M Shah |
First Address | Toms River, NJ 08753-2900 |
Second Address | Toms River, NJ 08753-2900 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 29/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02634499 | (05) | NY |