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General NPI Number Information
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NPI Number | 1649638446
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Entity Type | Organization
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Legal Business Name | ANJALI SHAH MD PC
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Dates
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Enumeration Date | 02/08/2016
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Last Update Date | 02/08/2016
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Provider Practice Location Address
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Address Line | 169 N PLANK RD
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City | NEWBURGH
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State | NY
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Zip | 12550-1723
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Country | US
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Telephone | 845-563-9055
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Fax | 845-917-9077
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Provider Business Mailing Address
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Address Line | 169 N PLANK RD
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City | NEWBURGH
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State | NY
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Zip | 12550-1723
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Country | US
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Telephone | 845-563-9055
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Fax | 845-917-9077
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANJALI N SHAH
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Credential | MD
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Telephone | 845-563-9055
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 233116
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License Number State | NY
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