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General NPI Number Information
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NPI Number | 1518005115
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Entity Type | Individual
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Provider Name | SHAILESH B. SHAH MS, RPH
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Gender | Male
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Dates
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Enumeration Date | 02/03/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 570 BLOOMFIELD AVE
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City | NEWARK
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State | NJ
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Zip | 07107-1346
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Country | US
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Telephone | 973-482-6753
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Fax | 973-482-0356
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Provider Business Mailing Address
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Address Line | 25 YALE CT
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City | LIVINGSTON
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State | NJ
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Zip | 07039-1519
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Country | US
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Telephone | 973-533-0269
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Fax | 973-533-0369
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 26RI01963800
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License Number State | NJ
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