Individual
NISHANT KISHOR SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2100 WESCOTT DR, FLEMINGTON, NJ 08822-4603
(908) 495-6325
(908) 788-6106
Mailing address
629 CRANBURY RD FL 2, EAST BRUNSWICK, NJ 08816-4096
(732) 390-7750
(732) 390-7725
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MT215574
PA
2085R0001X
Radiation Oncology Physician
Primary
25MA11777300
NJ
2085R0001X
Radiation Oncology Physician
MD473453
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0911381
—
NJ
01
—
15838318
CAQH ID
NJ
Enumeration date
04/18/2018
Last updated
06/27/2023
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