Individual
DR. AMIT RAJENDRA SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
450 SUNRISE HWY, MASSAPEQUA PARK, NY 11762-2901
(516) 809-9217
Mailing address
2 EVANS DR, GLEN HEAD, NY 11545-3145
(347) 701-1041
(718) 918-5593
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
250719
NY
2086S0129X
Vascular Surgery Physician
Primary
250719
NY
Other
Enumeration date
02/27/2010
Last updated
12/19/2023
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