Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 22DI02763800 | NJ |
NPI | 1326699851 |
---|---|
Provider Name | Dr. Ami Shah |
First Address | Carteret, NJ 07008-2553 |
Second Address | Hillsborough, NJ 08844-4260 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2019 |
Last Update Date | 26/06/2021 |