# 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:** 1861676280
- **Legal business name:** JAY H AND VIJAYA J SHAH MD
- **Authorized official:** JAY H SHAH MD (OWNER)
- **Authorized official phone:** (215) 322-9292

## Contact information

- **Practice address:** 862 SECOND STREET PIKE, RICHBORO, PA 18954-1005
- **Practice address phone:** (215) 322-9292
- **Mailing address:** 862 SECOND STREET PIKE, RICHBORO, PA 18954-1005
- **Mailing address phone:** (215) 322-9292

## Taxonomy

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

## Other

- **Enumeration date:** 12/20/2007
- **Last updated:** 12/20/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0008385670001 | — | PA |
| 05 | — | 0010343440001 | — | PA |
| 01 | — | 0423947001 | IBC-HMO | PA |
| 01 | — | 1004967 | KEY STONE MERCY | PA |