MEDICARE: HARISH H SHAH MD

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
1	207RH0003X	Hematology & Oncology Physician	MA34100	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619952181
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HARISH H SHAH MD

Provider Business Mailing Address
First Line	:	468 PARISH DR
Second Line	:	SUITE 4
City	:	WAYNE
State	:	NJ
Zip	:	07470-4671
Country	:	US
Telephone Number	:	973-694-5005
Fax Number	:	973-694-5990

Provider Business Practice Location Address
First Line	:	468 PARISH DR
Second Line	:	SUITE 4
City	:	WAYNE
State	:	NJ
Zip	:	07470-4671
Country	:	US
Telephone Number	:	973-694-5005
Fax Number	:	973-694-5990

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/07/2005
Last Update Date	:	05/02/2008

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Directions to “ HARISH H SHAH MD” Practice Location

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