Healthcare Provider Details

I. General information

NPI: 1730686882
Provider Name (Legal Business Name): AADIT SHAH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2018
Last Update Date: 05/16/2023
Certification Date: 05/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HSC T-18 - 089
STONY BROOK NY
11794-0001
US

IV. Provider business mailing address

2485 CEDAR SWAMP RD
GLEN HEAD NY
11545-3112
US

V. Phone/Fax

Practice location:
  • Phone: 631-444-1487
  • Fax: 631-444-3502
Mailing address:
  • Phone: 516-850-2047
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number310136
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: