Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 25MD00280000 | NJ |
NPI | 1063400026 |
---|---|
Provider Name | Dr. Amit Kirit Shah |
First Address | Piscataway, NJ 08854 |
Second Address | Fords, NJ 08863-2162 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2005 |
Last Update Date | 02/10/2012 |