# AMIT R SHAH VASCUAR SURGERY PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902567068
- **Authorized official:** AMIT RAHENDRA SHAH MD (OWNER)
- **Authorized official phone:** (718) 439-5111

## Contact information

- **Practice address:** 7404 5TH AVE, BROOKLYN, NY 11209-2704
- **Practice address phone:** (718) 439-5111
- **Practice address fax:** (516) 301-5939
- **Mailing address:** 2 EVANS DR, GLEN HEAD, NY 11545-3145
- **Mailing address phone:** (718) 439-5111
- **Mailing address fax:** (516) 301-5939

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | — | NULL | Yes |
| 2086S0129X | Vascular Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/31/2021
- **Last updated:** 12/31/2021