Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 25MD00318100 | NJ |
NPI | 1033406921 |
---|---|
Provider Name | Dr. Taral Shah |
First Address | Sewell, NJ 08080-2237 |
Second Address | Sewell, NJ 08080-2237 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2011 |
Last Update Date | 15/06/2020 |