Healthcare Provider Details

I. General information

NPI: 1669009254
Provider Name (Legal Business Name): NIRALI SHAH DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2020
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

822 MONTGOMERY AVE
NARBERTH PA
19072-1937
US

IV. Provider business mailing address

822 MONTGOMERY AVE
NARBERTH PA
19072-1937
US

V. Phone/Fax

Practice location:
  • Phone: 336-716-4551
  • Fax:
Mailing address:
  • Phone: 336-716-4551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberOS026238
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: