# SHAH MEDICAL GROUP LLP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Surendra and Mrudula Shah
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194816397
- **Authorized official:** SURENDRALAL G. SHAH MD (MD)
- **Authorized official phone:** (516) 822-4706

## Contact information

- **Practice address:** 528 OLD COUNTRY ROAD, PLAINVIEW, NY 11803-4997
- **Practice address phone:** (516) 822-4706
- **Practice address fax:** (516) 822-1373
- **Mailing address:** 528 OLD COUNTRY ROAD, PLAINVIEW, NY 11803-4997
- **Mailing address phone:** (516) 822-4706
- **Mailing address fax:** (516) 822-1373

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 133617 | NY | — |
| 207R00000X | Internal Medicine Physician | 144360 | NY | — |
| 207RH0003X | Hematology & Oncology Physician | 143360 | NY | Yes |
| 207RN0300X | Nephrology Physician | 133617 | NY | — |

## Other

- **Enumeration date:** 09/27/2006
- **Last updated:** 10/12/2010