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General NPI Number Information
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NPI Number | 1386162089
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Entity Type | Organization
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Legal Business Name | SAPNA SHAH FAMILY MEDICINE PC
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Dates
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Enumeration Date | 09/01/2017
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 1575 HILLSIDE AVE STE 203
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City | NEW HYDE PARK
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State | NY
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Zip | 11040-2501
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Country | US
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Telephone | 718-570-7856
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Fax | 516-517-9515
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Provider Business Mailing Address
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Address Line | 32 CRESTHOLLOW LN
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City | ALBERTSON
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State | NY
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Zip | 11507-1047
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Country | US
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Telephone | 718-570-7856
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Fax | 516-517-9515
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Authorized Official
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Title or Position | OWNER
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Name | SAPNA SHAH
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Credential | MD
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Telephone | 718-570-7856
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 249371
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License Number State | NY
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