MEDICARE: BILAL SHAH PA-C

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	363A00000X	Physician Assistant	028450	NY

General Provider Information

NPI Number	:	1689306268
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BILAL SHAH PA-C

Provider Business Mailing Address
First Line	:	28 ELK RIVER RD
Second Line	:
City	:	WEST HENRIETTA
State	:	NY
Zip	:	14586-9632
Country	:	US
Telephone Number	:	585-703-5639
Fax Number	:

Provider Business Practice Location Address
First Line	:	1881 MONROE AVE
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14618-1902
Country	:	US
Telephone Number	:	585-613-3099
Fax Number	:

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

Provider Enumeration Date	:	06/30/2022
Last Update Date	:	06/20/2024

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Directions to “ BILAL SHAH PA-C” Practice Location

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