Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | MA072768 | NJ |
NPI | 1225066491 |
---|---|
Provider Name | Dr. Utpal Suresh Shah |
First Address | East Windsor, NJ 08520-1411 |
Second Address | East Windsor, NJ 08520-1411 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2006 |
Last Update Date | 08/07/2007 |