Individual
DR. UDAY NIRANJAN SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4112 JUDGE ST, ELMHURST, NY 11373-2344
(718) 779-6666
(516) 651-3053
Mailing address
2156 IRONWOOD RD, MUTTONTOWN, NY 11791-9662
(516) 921-2476
(516) 921-0985
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
0225560
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02355604
—
NY
Enumeration date
03/28/2006
Last updated
02/18/2014
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