Individual
AMY SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
800 POLY PL, BROOKLYN, NY 11209-7104
(718) 836-6600
Mailing address
PO BOX 1262, BROOKLYN, NY 11202-1262
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
009432
NY
Other
Enumeration date
08/05/2021
Last updated
08/05/2021
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