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General NPI Number Information
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NPI Number | 1043640568
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Entity Type | Organization
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Legal Business Name | AMIT SHAH DPM, LLC
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Dates
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Enumeration Date | 11/19/2013
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Last Update Date | 12/20/2019
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Provider Practice Location Address
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Address Line | 619 AMBOY AVE
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City | EDISON
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State | NJ
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Zip | 08837-3584
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Country | US
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Telephone | 732-297-9535
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Fax | 732-297-8421
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Provider Business Mailing Address
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Address Line | 2864 ROUTE 27 STE I
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City | NORTH BRUNSWICK
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State | NJ
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Zip | 08902-5010
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Country | US
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Telephone | 732-297-9535
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | AMIT K SHAH
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Credential | DPM
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Telephone | 732-297-9535
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 25MD00280000
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License Number State | NJ
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