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Individual

KHALEDA SHAH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
B.S., N.C.P.T.

Contact information

Practice address
69 PEMBROKE AVE, BUFFALO, NY 14215-3131
(716) 218-0577
Mailing address
69 PEMBROKE AVE, BUFFALO, NY 14215-3131
(716) 218-0577

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
172V00000X
Community Health Worker
246RP1900X
Phlebotomy Technician
Primary

Other

Enumeration date
03/29/2024
Last updated
10/26/2024
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