Individual
DR. KAVITHA SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
1135 BROAD ST, CLIFTON, NJ 07013-3346
(973) 754-4100
Mailing address
1135 BROAD ST, CLIFTON, NJ 07013-3346
(973) 754-4100
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MA09499600
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/25/2011
Last updated
10/20/2020
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