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General NPI Number Information
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NPI Number | 1588110381
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Entity Type | Organization
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Legal Business Name | CHILDREN'S ASTHMA AND LUNG SPECIALISTS LLC
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Dates
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Enumeration Date | 08/31/2016
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Last Update Date | 08/31/2016
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Provider Practice Location Address
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Address Line | 3086 ROUTE 27 SUITE 10
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City | KENDALL PARK
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State | NJ
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Zip | 08824-1658
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Country | US
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Telephone | 844-543-5864
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Fax | 844-314-1144
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Provider Business Mailing Address
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Address Line | 3086 ROUTE 27 SUITE 10
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City | KENDALL PARK
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State | NJ
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Zip | 08824-1658
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Country | US
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Telephone | 844-543-5864
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Fax | 844-314-1144
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Authorized Official
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Title or Position | PEDIATRIC PULMONOLOGIST
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Name | DR. ASHISH C SHAH
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Credential | M.D.
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Telephone | 781-608-5170
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0214X
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Taxonomy Name | Pediatric Pulmonology Physician
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License Number | 25MA09774800
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License Number State | NJ
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