Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 43224 | AZ |
N | 2080P0207X | Pediatric Hematology-Oncologist | 55327 | CT |
NPI | 1134350499 |
---|---|
Provider Name | Dr. Niketa C Shah |
First Address | New Haven, CT 06510-3218 |
Second Address | New Haven, CT 06510-3218 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2009 |
Last Update Date | 14/06/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
548837 | (05) | AZ |