Provider Demographics
NPI:1225224017
Name:SHAH, PARTH S (MD)
Entity Type:Individual
Prefix:
First Name:PARTH
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 1:40 HART ST
Mailing Address - Street 2:BLDG C
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06052-1743
Mailing Address - Country:US
Mailing Address - Phone:860-229-8889
Mailing Address - Fax:860-229-8893
Practice Address - Street 1:40 HART ST
Practice Address - Street 2:BLDG C
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06052-1743
Practice Address - Country:US
Practice Address - Phone:860-229-8889
Practice Address - Fax:860-229-8893
Is Sole Proprietor?:No
Enumeration Date:2007-09-14
Last Update Date:2013-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0492462086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT061200871OtherPRIVATE HEALTHCARE SYSTEMS
CT061200871OtherGREAT WEST
CT061200871OtherNORTHEAST HEALTH DIRECT
CT1225224017OtherANTHEM BCBS
CT061200871OtherCORVEL
CT061200871OtherHEALTH NEW ENGLAND
CT061200871OtherUNITED HEALTHCARE
CT061200871OtherMULTIPLAN
CT1225224017Medicaid
CT061200871OtherTRICARE