Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | 21171 | NH |
N | 208000000X | Pediatrician | 21171 | NH |
NPI | 1699157982 |
---|---|
Provider Name | Dr. Nidhi D Shah |
First Address | Lebanon, NH 03756-0001 |
Second Address | Lebanon, NH 03756-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2015 |
Last Update Date | 24/05/2021 |