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General NPI Number Information
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NPI Number | 1558360495
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Entity Type | Individual
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Provider Name | VIJAY P SHAH M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/20/2005
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Last Update Date | 02/20/2012
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Provider Practice Location Address
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Address Line | 10 NATHAN D PERLMAN PLACE SUITE 12S34
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City | NEW YORK
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State | NY
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Zip | 10003-3851
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Country | US
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Telephone | 212-420-2124
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Fax | 212-420-3449
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Provider Business Mailing Address
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Address Line | 1900 HEMPSTEAD TPKE SUITE 500
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City | EAST MEADOW
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State | NY
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Zip | 11554-1724
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Country | US
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Telephone | 516-542-1090
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Fax | 770-666-9097
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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 | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 119384
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207ZH0000X
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Taxonomy Name | Hematology (Pathology) Physician
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License Number | 119384
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207ZB0001X
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Taxonomy Name | Blood Banking & Transfusion Medicine Physician
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License Number | 119384
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License Number State | NY
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