Organization
ELITE INTERNAL MEDICINE, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAZIA SHAH D.O. (CORPORATE PRESIDENT)
(609) 433-1255
Entity
Organization
Contact information
Practice address
601 HAMILTON AVE, TRENTON, NJ 08629-1915
(609) 599-5000
Mailing address
90 ALEXANDER AVE, HAMILTON, NJ 08619-1212
(609) 433-1255
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8757909
—
NJ
Enumeration date
04/18/2007
Last updated
04/22/2008
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