Healthcare Provider Details

I. General information

NPI: 1396033437
Provider Name (Legal Business Name): RUCHIR ASHWINBHAI SHAH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2011
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MADISON AVE
MORRISTOWN NJ
07960-6136
US

IV. Provider business mailing address

465 SOUTH ST STE 103
MORRISTOWN NJ
07960-6442
US

V. Phone/Fax

Practice location:
  • Phone: 973-971-5198
  • Fax: 973-605-8854
Mailing address:
  • Phone: 973-971-5198
  • Fax: 973-605-8854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number2015-00864
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberME143061
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number337993
License Number StateLA
# 4
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number53888
License Number StateTN
# 5
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number01082180A
License Number StateIN
# 6
Primary TaxonomyN
Taxonomy Code2084V0102X
TaxonomyVascular Neurology Physician
License Number53888
License Number StateTN
# 7
Primary TaxonomyN
Taxonomy Code2084V0102X
TaxonomyVascular Neurology Physician
License Number2015-00864
License Number StateNC
# 8
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number25MA11699900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: