Provider Demographics
NPI:1073794087
Name:CHIRAG S SHAH MD LLC
Entity Type:Organization
Organization Name:CHIRAG S SHAH MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:CHIRAG
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-895-6655
Mailing Address - Street 1:1 CARDIFF CT
Mailing Address - Street 2:
Mailing Address - City:WEST WINDSOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08550-3268
Mailing Address - Country:US
Mailing Address - Phone:609-895-6655
Mailing Address - Fax:
Practice Address - Street 1:3100 PRINCETON PIKE
Practice Address - Street 2:BLDG 4
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-2300
Practice Address - Country:US
Practice Address - Phone:609-895-6655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-19
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
2K1894OtherHEALTHNET
1167510OtherHORIZON NJ HEALTH
P2640513OtherOXFORD
2127852000OtherAMERIHEALTH
2127852000OtherAMERIHEALTH