Organization
JYOTI M SHAH PHYSICIAN P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JYOTI M SHAH M.D. (OWNER)
(516) 410-4792
Entity
Organization
Contact information
Practice address
18811 HILLSIDE AVE, HOLLIS, NY 11423-1935
(718) 264-6703
Mailing address
PO BOX 270, MASSAPEQUA PARK, NY 11762-0270
(631) 264-2035
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
169615
NY
Other
Enumeration date
01/10/2013
Last updated
01/10/2013
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