Individual
RAJAN S SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1060 BROAD ST, NEWARK, NJ 07102
(973) 642-0280
(973) 642-0047
Mailing address
95 FALCON RD, LIVINGSTON, NJ 07039
(973) 642-0280
(973) 642-0047
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MA40413
NJ
207RG0100X
Gastroenterology Physician
Primary
MA40413
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0560901
—
NJ
Enumeration date
06/26/2006
Last updated
10/19/2012
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