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General NPI Number Information
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NPI Number | 1790848083
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Entity Type | Individual
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Provider Name | DARSHAN T SHAH MD
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Gender | Male
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 796 DREW STREET SUITE A
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City | BROOKLYN
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State | NY
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Zip | 11208-4704
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Country | US
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Telephone | 718-827-7654
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Fax | 718-235-6425
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Provider Business Mailing Address
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Address Line | 238 BROOKVILLE ROAD DARSHAN SHAH MD MUTTONTOWN
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City | GLENHEAD
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State | NY
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Zip | 11545-3310
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Country | US
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Telephone |
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 128759
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License Number State | NY
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