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General NPI Number Information
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NPI Number | 1891613238
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Entity Type | Individual
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Provider Name | SAMARTH KETANKUMAR SHAH MD
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Gender | Male
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Dates
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Enumeration Date | 07/06/2026
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Last Update Date | 07/06/2026
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Provider Practice Location Address
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Address Line | 25 POCONO RD
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City | DENVILLE
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State | NJ
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Zip | 07834-2954
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Country | US
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Telephone | 973-625-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 2435 SW 22ND AVE APT 203
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City | DELRAY BEACH
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State | FL
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Zip | 33445-7727
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Country | US
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Telephone | 352-709-8631
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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