Individual
PRAFULLA SHAH
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1000 GALLOPING HILL RD, UNION, NJ 07083-7951
(908) 851-7161
Mailing address
PO BOX 67, KENILWORTH, NJ 07033-0067
(201) 487-7227
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
36889
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0622401
—
NJ
Enumeration date
06/14/2006
Last updated
07/08/2007
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