MEDICARE: DR. MEHUL R 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	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician	232762	NY

General Provider Information

NPI Number	:	1851583819
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MEHUL R SHAH M.D.

Provider Business Mailing Address
First Line	:	1999 MARCUS AVE STE 202
Second Line	:
City	:	NEW HYDE PARK
State	:	NY
Zip	:	11042-1021
Country	:	US
Telephone Number	:	516-467-8600
Fax Number	:

Provider Business Practice Location Address
First Line	:	1999 MARCUS AVE STE 202
Second Line	:
City	:	NEW HYDE PARK
State	:	NY
Zip	:	11042-1021
Country	:	US
Telephone Number	:	516-467-8600
Fax Number	:

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

Provider Enumeration Date	:	08/14/2007
Last Update Date	:	01/02/2024

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Directions to “ DR. MEHUL R SHAH M.D.” Practice Location

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