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NPI Code Detail

MEDICARE: DARSHAN T SHAH MD

MEDICARE: DARSHAN T 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
1207RC0000XCardiovascular Disease Physician128759NY

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 : 1790848083
Entity Type Code : Individual
Provider Name (Legal Business Name) : DARSHAN T SHAH MD
Provider Business Mailing Address
First Line : 238 BROOKVILLE ROAD
Second Line : DARSHAN SHAH MD MUTTONTOWN
City : GLENHEAD
State : NY
Zip : 11545-3310
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 796 DREW STREET
Second Line : SUITE A
City : BROOKLYN
State : NY
Zip : 11208-4704
Country : US
Telephone Number : 718-827-7654
Fax Number : 718-235-6425
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/18/2006
Last Update Date : 07/08/2007

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