Individual
DR. KETAN D. SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
9234 KENNEDY BLVD, NORTH BERGEN, NJ 07047-5312
(201) 868-2400
(201) 868-2014
Mailing address
9234 KENNEDY BLVD, NORTH BERGEN, NJ 07047-5312
(201) 868-2400
(201) 868-2014
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
25MD00270100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8882401
—
NJ
Enumeration date
05/25/2006
Last updated
03/31/2008
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