Individual
NITANT SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 HICKS AVE, SYOSSET, NY 11791-5836
(516) 508-6865
Mailing address
1 HICKS AVE, SYOSSET, NY 11791-5836
(516) 508-6865
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
433052
NY
Other
Enumeration date
07/30/2024
Last updated
07/30/2024
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