Provider Demographics
NPI:1184682593
Name:SHAH, RAJNIKANT S (MD)
Entity Type:Individual
Prefix:
First Name:RAJNIKANT
Middle Name:S
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 1:1177 UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-2861
Mailing Address - Country:US
Mailing Address - Phone:215-431-8326
Mailing Address - Fax:215-493-8879
Practice Address - Street 1:240 MIDDLETOWN BLVD STE 101C
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1832
Practice Address - Country:US
Practice Address - Phone:215-550-9999
Practice Address - Fax:215-857-9572
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04547900207RC0000X
PAMD034357L207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0007633680019Medicaid
NJ5345006Medicaid
NJ5345006Medicaid
PA105140Medicare ID - Type Unspecified
PA0007633680019Medicaid