Individual
DR. MAMTA A SHAHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
12 SPLIT ROCK DR, GREAT NECK, NY 11024-1127
(516) 487-1852
Mailing address
12 SPLIT ROCK DR, GREAT NECK, NY 11024-1127
(516) 487-1852
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
NY146203
NY
Other
Enumeration date
06/18/2012
Last updated
06/18/2012
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