Individual
MANAN SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7600 RIVER RD, NORTH BERGEN, NJ 07047-6217
(973) 980-3021
Mailing address
1716 41ST ST APT C, NORTH BERGEN, NJ 07047-2561
(201) 710-0716
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101272472
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/30/2018
Last updated
11/17/2021
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