Organization
VIJAYKUMAR SHAH MD P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VIJAYKUMAR R SHAH MD (OWNER)
(516) 626-5330
Entity
Organization
Contact information
Practice address
129 BROADWAY, AMITYVILLE, NY 11701-2729
(516) 626-5330
(516) 626-6527
Mailing address
2485 CEDAR SWAMP RD, GLEN HEAD, NY 11545-3112
(516) 626-5330
(516) 626-6527
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
186592
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
186592
LICENCE
NY
Enumeration date
04/16/2008
Last updated
04/16/2008
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