Individual
RIA SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5501 OLD YORK RD, PHILADELPHIA, PA 19141-3018
(215) 456-7890
Mailing address
5501 OLD YORK RD, PHILADELPHIA, PA 19141-3018
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
OT022098
PA
Other
Enumeration date
06/16/2022
Last updated
06/16/2022
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