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NPI Code Detail

MEDICARE: NILAY SHAH MD PC

MEDICARE: NILAY SHAH MD PC
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
12084N0400XNeurology Physician

General Provider Information

NPI Number : 1578696605
Entity Type Code : Organization
Provider Name (Legal Business Name) : NILAY SHAH MD PC
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 : 201-880-8061
Authorized Official
Title or Position : OWNER
Name : DR. NILAY SHAH
Credential : M.D.
Telephone Number : 201-880-8060
Provider Enumeration Date : 03/14/2007
Last Update Date : 07/17/2020

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