Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 215039 | NY |
Y | 207RP1001X | Pulmonary Disease | 215039 | NY |
NPI | 1043239163 |
---|---|
Provider Name | Lori Shah |
First Address | New York, NY 10032-3720 |
Second Address | New York, NY 10032-3720 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2006 |
Last Update Date | 17/03/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I18045 | (02) |