Individual
DR. KIRTIDA J SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
3455 BOSTON RD, BRONX, NY 10469-2508
(718) 798-2236
(718) 798-0561
Mailing address
20 ILINKA LN, IRVINGTON, NY 10533-2333
(914) 591-6770
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
034566
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00409834
—
NY
Enumeration date
10/06/2006
Last updated
07/08/2007
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