Individual
KETKI S SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1276 FULTON AVE, BRONX, NY 10456-3402
(718) 901-8445
(718) 901-6490
Mailing address
591 MILL RUN, PARAMUS, NJ 07652-1754
(201) 612-7732
(201) 612-3692
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
173995
NY
Other
Enumeration date
10/04/2006
Last updated
08/15/2014
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