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NPI Code Detail

MEDICARE: PARMENDRA SHAH

MEDICARE: PARMENDRA SHAH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianP140412NY

General Provider Information

NPI Number : 1164381034
Entity Type Code : Individual
Provider Name (Legal Business Name) : PARMENDRA SHAH
Provider Business Mailing Address
First Line : 3331 CARMINE AVE
Second Line :
City : GRANITEVILLE
State : SC
Zip : 29829-3290
Country : US
Telephone Number : 516-862-1202
Fax Number :
Provider Business Practice Location Address
First Line : 331 RUSSELL ST
Second Line :
City : CHITTENANGO
State : NY
Zip : 13037-1201
Country : US
Telephone Number : 315-687-7255
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2026
Last Update Date : 01/16/2026

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Directions to “ PARMENDRA SHAH ” Practice Location

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