Individual
SURENDRALAL G. SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
528 OLD COUNTRY ROAD, PLAINVIEW, NY 11803-4997
(516) 822-4706
(516) 822-1373
Mailing address
528 OLD COUNTRY ROAD, PLAINVIEW, NY 11803-4997
(516) 822-4706
(516) 822-1373
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
133617
NY
207RN0300X
Nephrology Physician
Primary
133617
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00725493
—
NY
Enumeration date
10/24/2006
Last updated
10/08/2010
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