Organization
JAY H AND VIJAYA J SHAH MD
Active
Parent organization
JAY H AND VIJAYA J SHAH MD
Organization subpart
Yes
Provider details
NPI number
Legal business name
JAY H AND VIJAYA J SHAH MD
Authorized official
JAY H SHAH MD (OWNER)
(215) 322-9292
Entity
Organization
Contact information
Practice address
862 SECOND STREET PIKE, RICHBORO, PA 18954-1005
(215) 322-9292
Mailing address
862 SECOND STREET PIKE, RICHBORO, PA 18954-1005
(215) 322-9292
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0008385670001
—
PA
05
—
0010343440001
—
PA
01
—
0423947001
IBC-HMO
PA
01
—
1004967
KEY STONE MERCY
PA
Enumeration date
12/20/2007
Last updated
12/20/2007
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