# JAY H AND VIJAYA J SHAH MD

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** JAY H AND VIJAYA J SHAH MD
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1104889484
- **Legal business name:** JAY H AND VIJAYA J SHAH MD
- **Authorized official:** JAY H SHAH MD (PHYSICIAN-OWNER)
- **Authorized official phone:** (215) 322-9292

## Contact information

- **Practice address:** 2562 KNIGHTS RD, BENSALEM, PA 19020-3400
- **Practice address phone:** (215) 244-6363
- **Practice address fax:** (215) 244-6365
- **Mailing address:** 862 SECOND STREET PIKE, RICHBORO, PA 18954-1005
- **Mailing address phone:** (215) 322-9292
- **Mailing address fax:** (215) 322-4394

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/08/2006
- **Last updated:** 12/20/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0008385670005 | — | PA |
| 05 | — | 0010343440006 | — | PA |
| 01 | — | 0423947002 | IBC-HMO | PA |
| 01 | — | 1017977 | KEY STONE MERCY-PA | PA |