MEDICARE: HIRNA SHAH

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	183500000X	Pharmacist	28RI02965000	NJ

General Provider Information

NPI Number	:	1518191857
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HIRNA SHAH

Provider Business Mailing Address
First Line	:	1437 43RD ST FL 2
Second Line	:
City	:	NORTH BERGEN
State	:	NJ
Zip	:	07047-2764
Country	:	US
Telephone Number	:	201-866-6919
Fax Number	:

Provider Business Practice Location Address
First Line	:	5706 BERGENLINE AVE
Second Line	:
City	:	WEST NEW YORK
State	:	NJ
Zip	:	07093-1230
Country	:	US
Telephone Number	:	201-869-8054
Fax Number	:

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

Provider Enumeration Date	:	05/14/2009
Last Update Date	:	05/14/2009

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Directions to “ HIRNA SHAH ” Practice Location

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