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NPI Code Detail

MEDICARE: NEEL SHAILESH SHAH DO

MEDICARE: NEEL SHAILESH SHAH DO
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
1207RI0011XInterventional Cardiology Physician25MB11283800NJ
2207RC0000XCardiovascular Disease Physician25MB11283800NJ

General Provider Information

NPI Number : 1487117164
Entity Type Code : Individual
Provider Name (Legal Business Name) : NEEL SHAILESH SHAH DO
Provider Business Mailing Address
First Line : 331 NEWMAN SPRINGS ROAD
Second Line : BLDG. 2, SUITE 220
City : RED BANK
State : NJ
Zip : 07701
Country : US
Telephone Number : 732-807-0877
Fax Number : 201-751-1680
Provider Business Practice Location Address
First Line : 30 PROSPECT AVE
Second Line :
City : HACKENSACK
State : NJ
Zip : 07601-1915
Country : US
Telephone Number : 551-996-4348
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2019
Last Update Date : 06/03/2026

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