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General NPI Number Information
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NPI Number | 1730251810
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Entity Type | Organization
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Legal Business Name | SUHAIL SHAH MD PC
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1483 BEECH LN
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City | EAST MEADOW
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State | NY
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Zip | 11554-3706
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Country | US
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Telephone | 516-292-6642
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Fax | 516-292-2558
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Provider Business Mailing Address
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Address Line | PO BOX 441
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City | EAST MEADOW
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State | NY
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Zip | 11554-0441
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Country | US
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Telephone | 516-292-6642
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Fax | 516-292-2558
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Authorized Official
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Title or Position | CEO
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Name | DR. SUHAIL A SHAH
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Credential | MD
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Telephone | 516-292-6642
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 206932
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License Number State | NY
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