Provider Demographics
NPI:1033406921
Name:SHAH, TARAL (DPM)
Entity Type:Individual
Prefix:DR
First Name:TARAL
Middle Name:
Last Name:SHAH
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:100 KINGS WAY E
Mailing Address - Street 2:SUITE D6
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-2237
Mailing Address - Country:US
Mailing Address - Phone:856-582-6082
Mailing Address - Fax:856-582-6083
Practice Address - Street 1:100 KINGS WAY E
Practice Address - Street 2:SUITE D6
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-2237
Practice Address - Country:US
Practice Address - Phone:856-582-6082
Practice Address - Fax:856-582-6083
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-30
Last Update Date:2020-06-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MD00318100213ES0103X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery