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General NPI Number Information
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NPI Number | 1003376849
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Entity Type | Individual
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Provider Name | NEIL VIJAY SHAH MD, MS
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Gender | Male
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Dates
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Enumeration Date | 03/20/2019
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 450 CLARKSON AVE # MSC30
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City | BROOKLYN
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State | NY
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Zip | 11203-2012
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Country | US
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Telephone | 718-270-2179
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Fax |
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Provider Business Mailing Address
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Address Line | 2485 CEDAR SWAMP RD
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City | GLEN HEAD
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State | NY
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Zip | 11545-3112
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | 337332
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 337332-01
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License Number State | NY
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