Individual
AMIE SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
315 MAIN ST STE 315-I, HOLBROOK, NY 11741-1524
(267) 210-1847
Mailing address
140 ADDIS DR, CHURCHVILLE, PA 18966-1170
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
058278
NY
1223P0221X
Pediatric Dentistry
Primary
058278
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/12/2014
Last updated
03/17/2018
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