Organization
EDEN HEALTH MEDICAL OF DE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAJAN SHAH MD (PRESIDENT)
(917) 261-4414
Entity
Organization
Contact information
Practice address
77 GOODELL ST STE 510, BUFFALO, NY 14203-1258
(917) 261-4414
Mailing address
77 GOODELL ST STE 510, BUFFALO, NY 14203-1258
(917) 261-4414
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
10/19/2021
Last updated
09/13/2024
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