Individual
ENASHA SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
330 W 58TH ST STE 301, NEW YORK, NY 10019-1801
(212) 769-4200
Mailing address
3179 35TH ST APT 1, ASTORIA, NY 11106-1503
(239) 728-4166
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
033086-01
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/17/2024
Last updated
05/01/2025
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