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General NPI Number Information
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NPI Number | 1922592880
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Entity Type | Individual
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Provider Name | VIVAN PRANAV SHAH MD
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Gender | Male
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Dates
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Enumeration Date | 06/14/2018
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Last Update Date | 11/26/2025
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Provider Practice Location Address
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Address Line | 1850 NORMANDIE DR
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City | YORK
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State | PA
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Zip | 17408-1534
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Country | US
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Telephone | 872-231-3162
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 22239
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City | NEW YORK
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State | NY
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Zip | 10087-0001
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Country | US
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Telephone | 702-899-0595
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Fax | 702-977-1496
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 01088086A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | MD479688
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License Number State | PA
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