Individual
PRADIP S SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
459 PASSAIC AVE, CRANE'S MILL - OAK HEALTH CENTER, WEST CALDWELL, NJ 07006-7457
(973) 276-3026
(973) 276-7881
Mailing address
57 MARTIN RD, LIVINGSTON, NJ 07039-4631
(973) 716-0052
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
MA062084
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7190701
—
NJ
Enumeration date
08/11/2006
Last updated
07/08/2007
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