Provider Demographics
NPI:1225062979
Name:SHAH-THUM, SEJAL SATISH (MD)
Entity Type:Individual
Prefix:DR
First Name:SEJAL
Middle Name:SATISH
Last Name:SHAH-THUM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SEJAL
Other - Middle Name:S
Other - Last Name:SHAH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:135 CENTRAL PARK W STE 1B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-2413
Mailing Address - Country:US
Mailing Address - Phone:646-543-6165
Mailing Address - Fax:877-991-6135
Practice Address - Street 1:135 CENTRAL PARK W STE 1B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-2413
Practice Address - Country:US
Practice Address - Phone:646-543-6165
Practice Address - Fax:877-991-6135
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2322092084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry