MEDICARE: DR. NILAY RAMESH SHAH MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0600X	Clinical Neurophysiology Physician	227852	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154372621
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NILAY RAMESH SHAH MD

Provider Business Mailing Address
First Line	:	255 W SPRING VALLEY AVE STE 102
Second Line	:
City	:	MAYWOOD
State	:	NJ
Zip	:	07607-1444
Country	:	US
Telephone Number	:	201-880-8060
Fax Number	:	201-880-8061

Provider Business Practice Location Address
First Line	:	255 W SPRING VALLEY AVE STE 102
Second Line	:
City	:	MAYWOOD
State	:	NJ
Zip	:	07607-1444
Country	:	US
Telephone Number	:	201-880-8060
Fax Number	:	201-301-8892

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	04/22/2025

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