Individual
DR. JAMIL MOHAMMAD SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
150 BERGEN ST, NEWARK, NJ 07103-2496
(516) 967-5157
Mailing address
899 WOODMERE DR, VALLEY STREAM, NY 11581-2735
(516) 967-5157
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
288883
NY
207RG0100X
Gastroenterology Physician
25MA10384700
NJ
207RG0100X
Gastroenterology Physician
Primary
288883
NY
Other
Enumeration date
11/15/2014
Last updated
05/01/2024
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