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General NPI Number Information
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NPI Number | 1801704796
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Entity Type | Individual
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Provider Name | UTKARSH SHAH RN
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Gender | Male
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Dates
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Enumeration Date | 08/31/2026
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Last Update Date | 08/31/2026
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Provider Practice Location Address
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Address Line | 900 FRANKLIN AVE
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City | VALLEY STREAM
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State | NY
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Zip | 11580-2145
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Country | US
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Telephone | 718-313-7535
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Fax |
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Provider Business Mailing Address
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Address Line | 921 LAKEVILLE RD
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City | NEW HYDE PARK
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State | NY
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Zip | 11040-3008
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Country | US
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Telephone | 718-313-7535
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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 | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 699001
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License Number State | NY
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