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NPI Code Detail

MEDICARE: SUMMIT MEDICAL ARTS ASSOCIATES, LLC

MEDICARE: SUMMIT MEDICAL ARTS ASSOCIATES, LLC
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
1207RC0200XCritical Care Medicine (Internal Medicine) Physician25MA05689400NJ
2207RC0000XCardiovascular Disease Physician25MA3560900NJ
3207RP1001XPulmonary Disease Physician25MA3560900NJ
4207R00000XInternal Medicine Physician25MA05689400NJ

Other Identifiers

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

General Provider Information

NPI Number : 1750473146
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUMMIT MEDICAL ARTS ASSOCIATES, LLC
Provider Business Mailing Address
First Line : 9225 KENNEDY BLVD
Second Line :
City : NORTH BERGEN
State : NJ
Zip : 07047-5361
Country : US
Telephone Number : 201-453-2800
Fax Number : 201-453-0182
Provider Business Practice Location Address
First Line : 9225 KENNEDY BLVD
Second Line :
City : NORTH BERGEN
State : NJ
Zip : 07047-5361
Country : US
Telephone Number : 201-453-2800
Fax Number : 201-453-0182
Authorized Official
Title or Position : OWNER
Name : DR. KAMALESH SHAH
Credential : M.D.
Telephone Number : 201-453-2800
Provider Enumeration Date : 09/29/2006
Last Update Date : 11/30/2016

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Directions to “SUMMIT MEDICAL ARTS ASSOCIATES, LLC ” Practice Location

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