Provider Demographics
NPI:1164401261
Name:SHAH, BHARTI C (MD)
Entity Type:Individual
Prefix:DR
First Name:BHARTI
Middle Name:C
Last Name:SHAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:BHARTI
Other - Middle Name:C
Other - Last Name:SHAH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:481 GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-3609
Mailing Address - Country:US
Mailing Address - Phone:732-549-1777
Mailing Address - Fax:732-494-8354
Practice Address - Street 1:481 GROVE AVE
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-3609
Practice Address - Country:US
Practice Address - Phone:732-549-1777
Practice Address - Fax:732-494-8354
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMA032846207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJE82805Medicare UPIN