Individual
DEEPA RASENDU SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
140 PARK AVE, FLORHAM PARK, NJ 07932-1049
(973) 404-7880
Mailing address
100 MADISON AVE, MORRISTOWN, NJ 07960-6136
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA11282100
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/27/2018
Last updated
12/22/2021
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