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General NPI Number Information
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NPI Number | 1215126180
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Entity Type | Organization
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Legal Business Name | BEHAVIORAL HEALTH SERVICES PC
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Dates
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Enumeration Date | 10/17/2007
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Last Update Date | 10/17/2007
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Provider Practice Location Address
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Address Line | 45 HARTLANDER ST
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-2668
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Country | US
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Telephone | 732-735-5898
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Fax | 732-613-7197
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Provider Business Mailing Address
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Address Line | 45 HARTLANDER ST
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-2668
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Country | US
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Telephone | 732-735-5898
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Fax | 732-613-7197
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Authorized Official
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Title or Position | PSYCHIATRIST
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Name | DR. KOMAL SAURABH SHAH
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Credential | M.D.
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Telephone | 732-735-5898
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MA072314
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License Number State | NJ
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