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General NPI Number Information
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NPI Number | 1336683473
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Entity Type | Individual
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Provider Name | SHREYA SAMIR AMIN M.D.
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Gender | Female
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Dates
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Enumeration Date | 12/08/2016
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Last Update Date | 07/18/2024
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Provider Practice Location Address
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Address Line | 19636 N 27TH AVE STE 408
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City | PHOENIX
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State | AZ
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Zip | 85027-4021
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Country | US
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Telephone | 623-780-0100
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Fax |
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Provider Business Mailing Address
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Address Line | 330 BROOKLINE AVE
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City | BOSTON
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State | MA
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Zip | 02215-5400
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Country | US
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Telephone | 617-667-7000
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 66182
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License Number State | AZ
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