Individual
DR. KULSOOM SHAH
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
1 STADIUM RD,STUDENT HEALTH CENTER,STONYBROOK UNIV, STONY BROOK, NY 11794-0001
(631) 632-6740
(631) 632-6936
Mailing address
52 AVALON CIR, SMITHTOWN, NY 11787-3855
(631) 863-1634
(631) 632-6936
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
224192-1
NY
Other
Enumeration date
05/23/2005
Last updated
07/08/2007
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