Individual
SHAILAJA K. SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
407 OMNI DR, HILLSBOROUGH, NJ 08844-4527
(732) 689-3832
Mailing address
407 OMNI DRIVE,, 407 OMNI DRIVE, HILLSBOROUGH, NJ 08844
(732) 689-3832
Taxonomy
Speciality
Code
Description
License number
State
2084P0805X
Geriatric Psychiatry Physician
Primary
25MA071269
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0023701
AGENCY MEDICAID PROVIDER
NJ
01
—
527486
AGENCY MEDICARE NUMBER
NJ
05
—
8489602
—
NJ
Enumeration date
10/24/2006
Last updated
01/13/2014
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