Individual
DR. INDRAVADAN C SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
454 E SHORE RD, GREAT NECK, NY 11024-1540
(516) 487-3924
(516) 487-3924
Mailing address
454 E SHORE RD, GREAT NECK, NY 11024-1540
(516) 487-3924
(516) 487-3924
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
110048
NY
208600000X
Surgery Physician
Primary
110048
NY
Other
Enumeration date
10/26/2006
Last updated
09/11/2025
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