Healthcare Provider Details

I. General information

NPI: 1407163330
Provider Name (Legal Business Name): TORAL SHAH P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2010
Last Update Date: 09/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 1ST AVENUE NYU LANGONE MEDICAL CENTER OBV A628
NEW YORK NY
10016
US

IV. Provider business mailing address

550 1ST AVENUE NYU LANGONE MEDICAL CENTER OBV A628
NEW YORK NY
10016
US

V. Phone/Fax

Practice location:
  • Phone: 212-263-7000
  • Fax: 212-263-7011
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number007588
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: