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Individual

MS. SHABNAM DHIRENDRA SHAH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSPA-C

Contact information

Practice address
126 STATE ST, HACKENSACK, NJ 07601-5448
(973) 504-6326
Mailing address
126 STATE ST, HACKENSACK, NJ 07601
(973) 504-6326

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00168300
NJ
363A00000X
Physician Assistant
25MP00168300
NY

Other

Enumeration date
05/03/2007
Last updated
07/12/2017
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