Organization
BAKHTIAR A SHAH MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BAKHTIAR A SHAH MD (DIRECTOR)
(718) 815-1000
Entity
Organization
Contact information
Practice address
130 AVENUE P, BROOKLYN, NY 11204-6362
(718) 815-1000
(718) 815-8122
Mailing address
302 MANOR ROAD, STATEN ISLAND, NY 10314
(718) 815-1000
(718) 815-8122
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
WANU71
GRP MCR
NY
Enumeration date
07/22/2006
Last updated
09/24/2008
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