Individual
DR. SANJAY R SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD. MBBS
Contact information
Practice address
246 HAMBURG TPKE, SUITE 207, WAYNE, NJ 07470-2156
(713) 294-7344
Mailing address
246 HAMBURG TPKE, SUITE 207, WAYNE, NJ 07470-2156
(713) 294-7344
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
25MA08671900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0223425
—
NJ
01
—
177336ACQ
MEDICARE PTAN
NJ
01
—
286040YQ5N
MEDICARE
TX
Enumeration date
07/01/2008
Last updated
01/22/2015
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