Individual
SIDDHARTH SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4000 PRESIDENTIAL BLVD APT 1119, PHILADELPHIA, PA 19131-1721
(732) 725-2323
Mailing address
4000 PRESIDENTIAL BLVD, APT# 1119, PHILADELPHIA, PA 19131
(732) 725-2323
Taxonomy
Speciality
Code
Description
License number
State
242T00000X
Perfusionist
Primary
129082
CA
Other
Enumeration date
02/28/2018
Last updated
02/28/2018
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