Healthcare Provider Details

I. General information

NPI: 1881323343
Provider Name (Legal Business Name): NASAR ALI SHAH MBBS (MD)
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2022
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 OAKWOOD TER STE 100
NEW WINDSOR NY
12553-7754
US

IV. Provider business mailing address

2 COATES DR
GOSHEN NY
10924-6758
US

V. Phone/Fax

Practice location:
  • Phone: 845-561-1270
  • Fax: 845-561-1428
Mailing address:
  • Phone: 845-651-1400
  • Fax: 845-651-1512

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number346422
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: