Organization
NORTHEAST KIDNEY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANKIT SHAH MD (AUTHORIZED OFFICIAL)
(732) 458-5854
Entity
Organization
Contact information
Practice address
210 JACK MARTIN BLVD STE D1, BRICK, NJ 08724-7771
(732) 458-5854
Mailing address
210 JACK MARTIN BLVD STE D1, BRICK, NJ 08724-7771
(732) 458-5854
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207RN0300X
Nephrology Physician
—
—
Other
Enumeration date
01/12/2024
Last updated
11/18/2024
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