Organization
SUDHA R SHAH MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUDHA R SHAH M.D. (PRESIDENT)
(718) 252-5550
Entity
Organization
Contact information
Practice address
3860 KINGS HWY, #1, BROOKLYN, NY 11234-2907
(718) 252-5550
(718) 258-1768
Mailing address
3860 KINGS HWY, #1, BROOKLYN, NY 11234-2907
(718) 252-5550
(718) 258-1768
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
133672
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00346814
—
NY
Enumeration date
12/20/2011
Last updated
02/07/2012
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