Provider Demographics
NPI:1205045309
Name:SHAH, BHARATI R (MD)
Entity Type:Individual
Prefix:MRS
First Name:BHARATI
Middle Name:R
Last Name:SHAH
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:9 WILBUR RD
Mailing Address - Street 2:HUDSON VALLEY DDSO
Mailing Address - City:THIELLS
Mailing Address - State:NY
Mailing Address - Zip Code:10984-0470
Mailing Address - Country:US
Mailing Address - Phone:845-947-6328
Mailing Address - Fax:845-947-6008
Practice Address - Street 1:9 WILBUR RD
Practice Address - Street 2:HUDSON VALLEY DDSO
Practice Address - City:THIELLS
Practice Address - State:NY
Practice Address - Zip Code:10984-0470
Practice Address - Country:US
Practice Address - Phone:845-947-6000
Practice Address - Fax:845-947-6008
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NYNY1154232080P0006X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics
Not Answered208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
E20031Medicare UPIN