Individual
MANOJ SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 BROOKDALE PLZ, BROOKLYN, NY 11212-3139
(718) 240-5000
Mailing address
195 JERICHO TPKE, OLD WESTBURY, NY 11568-1501
(516) 338-6842
(516) 338-6842
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
135666
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00314934
—
NY
Enumeration date
10/23/2006
Last updated
03/18/2016
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