Individual
NIRAV N SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
901 W MAIN ST, SUITE 160, CN 5050, FREEHOLD, NJ 07728-2537
(732) 577-0600
(732) 577-6332
Mailing address
901 W MAIN ST, SUITE 160, CN 5050, FREEHOLD, NJ 07728-2537
(732) 577-0600
(732) 577-6332
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
25MB08017800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0157481
—
NJ
01
—
6932758
AETNA HEALTH PLANS HMO
NJ
01
—
9958326
AETNA HEALTH PLANS PPO
NJ
01
—
P00746572
RR MEDICARE
NJ
01
—
P00801247
MEDICARE RAILROAD CARRIER
NJ
Enumeration date
05/25/2007
Last updated
04/06/2010
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