Individual
RUPAL BHAGAT SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
193 GRAND ST, BROOKLYN, NY 11211-4209
(910) 995-4889
Mailing address
416 S HANCOCK ST, ROCKINGHAM, NC 28379-4225
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
009691-01
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27OA00650500
STATE LICENSE NUMBER
NJ
Enumeration date
11/02/2013
Last updated
05/18/2023
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