Individual
DR. KUMUDINI SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
455 E BAY DR, LONG BEACH, NY 11561-2301
(516) 897-1408
Mailing address
18A ABINGTON AVE, ARDSLEY, NY 10502-2012
(914) 693-5845
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
148471-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
148471-1
NYS LICENSE NUBMER
NY
Enumeration date
11/03/2006
Last updated
07/08/2007
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