Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | MA50402 | NJ |
NPI | 1134168776 |
---|---|
Provider Name | Paresha S. Shah |
First Address | Turnersville, NJ 08012-3215 |
Second Address | Turnersville, NJ 08012-3215 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2006 |
Last Update Date | 17/04/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1264907 | (05) | NJ |
C33968 | (02) | NJ |