Individual
JAY SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4351 E LOHMAN AVE, LAS CRUCES, NM 88011-8259
(575) 556-7762
Mailing address
4351 E LOHMAN AVE, LAS CRUCES, NM 88011-8259
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
RS2024-0294
NM
Other
Enumeration date
06/20/2023
Last updated
10/08/2024
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