Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | 237069 | NY |
NPI | 1245267301 |
---|---|
Provider Name | Dr. Vikas Shah |
First Address | Brooklyn, NY 11215-3689 |
Second Address | Brooklyn, NY 11215-3689 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2006 |
Last Update Date | 08/07/2007 |