Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | P76213 | NY |
N | 222Z00000X | Podiatrist | P76213 | NY |
Y | 213EP1101X | Primary Podiatric Medicine | P76213 | NY |
NPI | 1225315716 |
---|---|
Provider Name | Dr. Nirav R Shah |
First Address | Denville, NJ 07834-9531 |
Second Address | Denville, NJ 07834-9531 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2011 |
Last Update Date | 16/12/2019 |