# SPECIALIST IN THORACIC SURGERY LLC

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

## Provider details

- **NPI number:** 1972804821
- **Authorized official:** DR. SHAMJI SHAH MD (PRESIDENT)
- **Authorized official phone:** (973) 313-0011

## Contact information

- **Practice address:** 96 MILLBURN AVE, STE200A, MILLBURN, NJ 07041-1944
- **Practice address phone:** (973) 313-0011
- **Practice address fax:** (973) 763-1589
- **Mailing address:** 96 MILLBURN AVE, STE200A, MILLBURN, NJ 07041-1944
- **Mailing address phone:** (973) 313-0011
- **Mailing address fax:** (973) 763-1589

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 25MA04588100 | NJ | Yes |

## Other

- **Enumeration date:** 11/09/2010
- **Last updated:** 11/09/2010