Provider Demographics
NPI:1164553012
Name:SHAH, MUNIR HUSSAIN (MD)
Entity Type:Individual
Prefix:DR
First Name:MUNIR
Middle Name:HUSSAIN
Last Name:SHAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 9TH ST
Mailing Address - Street 2:
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801-5448
Mailing Address - Country:US
Mailing Address - Phone:212-318-4038
Mailing Address - Fax:212-318-4037
Practice Address - Street 1:1 MAIN ST
Practice Address - Street 2:COLER-GOLDWATER SP. HOSPITAL & NURSING FACILITY
Practice Address - City:ROOSEVELT ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10044-0052
Practice Address - Country:US
Practice Address - Phone:212-318-4038
Practice Address - Fax:212-318-4037
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY211035207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine