Individual
ANJALI N SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
310 FULLERTON AVE, SUITE 101, NEWBURGH, NY 12550-3724
(845) 563-9055
(845) 913-9077
Mailing address
310 FULLERTON AVE, SUITE 101, NEWBURGH, NY 12550-3724
(845) 563-9055
(845) 913-9077
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
233116
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02593199
—
NY
01
—
P00463679
RAIL ROAD MEDICARE
—
Enumeration date
08/12/2006
Last updated
06/17/2008
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