Individual
DR. JYOTI R SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D. DFAPA
Contact information
Practice address
354 STANLEY DR, KINGSTON, PA 18704-5610
(570) 288-3903
(570) 288-3903
Mailing address
354 STANLEY DR, KINGSTON, PA 18704-5610
(570) 288-3903
(570) 288-3903
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD 023979E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1456970
—
PA
Enumeration date
05/04/2006
Last updated
07/08/2007
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