=====================================================
General NPI Number Information
=====================================================
NPI Number | 1013306687
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AASHVEE SHAH
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/20/2015
-----------------------------------------------------
Last Update Date | 01/20/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1633 E 8TH ST
-----------------------------------------------------
City | BROOKLYN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11223-2217
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-336-0265
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7000 JFK BLVD EAST APT 44 H
-----------------------------------------------------
City | GUTTENBERG
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07093-4859
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-580-1126
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | 038194
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------