Individual
ANUJ SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1 BROOKDALE PLZ, BROOKLYN, NY 11212-3139
(718) 240-6552
Mailing address
744 WOODSIDE DR, WANTAGH, NY 11793-1144
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/16/2016
Last updated
09/16/2016
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