Individual
DHIRAJ M SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
391 MYRTLE AVE., SUITE 5, THE VASCULAR GROUP, PLLC, ALBANY, NY 12208-3412
(518) 262-5640
(518) 262-9413
Mailing address
391 MYRTLE AVE STE 5, ALBANY, NY 12208-3797
(518) 262-5640
(518) 262-9413
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
119380
NY
2086S0129X
Vascular Surgery Physician
Primary
119380
NY
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
119380
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00567175
—
NY
01
—
00N60410
MEDICARE DOWN STATE
NY
Enumeration date
10/27/2005
Last updated
07/21/2022
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