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General NPI Number Information
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NPI Number | 1619642444
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Entity Type | Individual
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Provider Name | HARSH SHAH
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Gender | Male
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Dates
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Enumeration Date | 08/13/2021
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Last Update Date | 08/13/2021
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Provider Practice Location Address
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Address Line | 1914 LINCOLN HWY STE B
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City | EDISON
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State | NJ
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Zip | 08817
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Country | US
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Telephone | 732-272-0746
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Fax |
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Provider Business Mailing Address
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Address Line | 6 VILLAGE GATE WAY
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City | MONROE
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State | NY
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Zip | 10950-1548
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Country | US
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Telephone | 845-492-9977
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Fax |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 22DI02852600
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License Number State | NJ
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