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General NPI Number Information
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NPI Number | 1548393150
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Entity Type | Individual
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Provider Name | VINAY J SHAH MD
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Gender | Male
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1211 WHITE PLAINS RD
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City | BRONX
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State | NY
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Zip | 10472-4900
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Country | US
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Telephone | 718-828-6610
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Fax | 718-829-9132
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Provider Business Mailing Address
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Address Line | 153 SIBBALD DR
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City | PARK RIDGE
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State | NJ
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Zip | 07656-2329
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Country | US
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Telephone | 201-307-9671
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Fax | 718-829-9132
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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 | 207QA0000X
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Taxonomy Name | Adolescent Medicine (Family Medicine) Physician
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License Number | 166833
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License Number State | NY
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