Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 271301 | MA |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 272781 | NY |
NPI | 1114284288 |
---|---|
Provider Name | Dr. Sarav Shah |
First Address | Brighton, MA 02135-2065 |
Second Address | Brighton, MA 02135 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2012 |
Last Update Date | 11/08/2019 |