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NPI Code Detail

MEDICARE: DR. DEEPA V SHAH M.D.

MEDICARE: DR. DEEPA V SHAH M.D.
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
1207P00000XEmergency Medicine Physician036114190IL
2207R00000XInternal Medicine Physician244033NY
3207RH0002XHospice and Palliative Medicine (Internal Medicine) Physician244033NY
4208M00000XHospitalist Physician244033NY

General Provider Information

NPI Number : 1679545420
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DEEPA V SHAH M.D.
Provider Business Mailing Address
First Line : 5901 PALISADE AVE
Second Line :
City : BRONX
State : NY
Zip : 10471-1205
Country : US
Telephone Number : 718-581-1200
Fax Number : 718-581-1012
Provider Business Practice Location Address
First Line : 5141 BROADWAY
Second Line :
City : NEW YORK
State : NY
Zip : 10034-1159
Country : US
Telephone Number : 212-932-5218
Fax Number : 212-932-5258
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2006
Last Update Date : 08/16/2023

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