MEDICARE: DR. SAPNA R SHAH D.O.

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	207QA0505X	Adult Medicine Physician	216230	NY

General Provider Information

NPI Number	:	1629009923
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAPNA R SHAH D.O.

Provider Business Mailing Address
First Line	:	780 8TH AVE
Second Line	:	SUITE 303
City	:	NEW YORK
State	:	NY
Zip	:	10036-7000
Country	:	US
Telephone Number	:	212-641-4500
Fax Number	:	212-641-4508

Provider Business Practice Location Address
First Line	:	780 8TH AVE
Second Line	:	SUITE 303
City	:	NEW YORK
State	:	NY
Zip	:	10036-7000
Country	:	US
Telephone Number	:	212-641-4500
Fax Number	:	212-641-4508

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

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	08/15/2012

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Directions to “ DR. SAPNA R SHAH D.O.” Practice Location

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