MEDICARE: KRUTI SHAH M.D.

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	208M00000X	Hospitalist Physician	67128	AZ
2	207R00000X	Internal Medicine Physician	304699	NY

General Provider Information

NPI Number	:	1659803518
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRUTI SHAH M.D.

Provider Business Mailing Address
First Line	:	500 7TH AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10018-4502
Country	:	US
Telephone Number	:	833-947-4927
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 7TH AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10018-4502
Country	:	US
Telephone Number	:	833-947-4927
Fax Number	:

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

Provider Enumeration Date	:	03/30/2017
Last Update Date	:	07/10/2023

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Directions to “ KRUTI SHAH M.D.” Practice Location

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