Individual
KISHAN BHARAT SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
185 S ORANGE AVE, NEWARK, NJ 07103-2757
(609) 496-0126
Mailing address
331 NEWMAN SPRINGS RD STE 220, RED BANK, NJ 07701-5792
(732) 807-0877
(201) 751-1680
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
25MA12415400
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/28/2020
Last updated
10/16/2024
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