Individual
DR. REZA ALI SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2063 KLOCKNER RD, HAMILTON, NJ 08690-3414
(609) 586-9788
(609) 586-1232
Mailing address
PO BOX 3444, MERCERVILLE, NJ 08619-0444
(609) 586-9788
(609) 586-1323
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
25MB06764700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
203985484
TAX ID
NJ
01
—
2039854840
HORIZON
NJ
01
—
2690963000
AMERIHEALTH
NJ
01
—
3K2190
HEALTHNET
NJ
01
—
5727757
AETNA
NJ
01
—
60032148
HORIZON NJ HEALTH
NJ
01
—
7180223002
CIGNA
NJ
01
—
7279755
UNITED HEALTHCARE
NJ
05
—
7947801
—
NJ
01
—
P1626337
OXFORD
NJ
Enumeration date
05/24/2006
Last updated
06/24/2008
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