# DR. REZA ALI SHAH

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1891740080
- **Gender:** Man
- **Credential:** DO

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | 25MB06764700 | NJ | Yes |

## Other

- **Enumeration date:** 05/24/2006
- **Last updated:** 06/24/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 203985484 | TAX ID | NJ |
| 01 | — | 2039854840 | HORIZON | NJ |
| 01 | — | 2690963000 | AMERIHEALTH | NJ |
| 01 | — | 3K2190 | HEALTHNET | NJ |
| 01 | — | 5727757 | AETNA | NJ |
| 01 | — | 60032148 | HORIZON NJ HEALTH | NJ |
| 01 | — | 7180223002 | CIGNA | NJ |
| 01 | — | 7279755 | UNITED HEALTHCARE | NJ |
| 05 | — | 7947801 | — | NJ |
| 01 | — | P1626337 | OXFORD | NJ |