Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 245798 | MA |
N | 208600000X | Surgeon | 245798 | MA |
N | 208200000X | Surgeon | 249696 | MA |
N | 208600000X | Surgeon | 249696 | MA |
N | 208200000X | Surgeon | 283719 | NY |
N | 208600000X | Surgeon | 283719 | NY |
N | 208200000X | Surgeon | MD444490 | PA |
N | 208600000X | Surgeon | MD444490 | PA |
N | 2086S0102X | Surgical Critical Care | 283719 | NY |
Y | 2086S0102X | Surgical Critical Care | MD444490 | PA |
NPI | 1053563072 |
---|---|
Provider Name | Dr. Niral A Shah |
First Address | Sayre, PA 18840-1625 |
Second Address | Sayre, PA 18840-1625 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/10/2008 |
Last Update Date | 06/01/2017 |