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Individual
DR. LISA JITENDRA SHAH
Active
Individual
DR. LISA JITENDRA SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
231392
NY
207QA0505X
Adult Medicine Physician
OS014477
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02706081
—
NY
01
—
231392
LICENSE
NY
Enumeration date
02/14/2007
Last updated
01/30/2012
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