Provider Demographics
NPI:1275793705
Name:NEHA SHAH MD LLC
Entity Type:Organization
Organization Name:NEHA SHAH MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:NEHABAHEN
Authorized Official - Middle Name:V
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-444-6190
Mailing Address - Street 1:84 KENNEDY ST
Mailing Address - Street 2:
Mailing Address - City:ISELIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08830-1741
Mailing Address - Country:US
Mailing Address - Phone:908-444-6190
Mailing Address - Fax:
Practice Address - Street 1:2141 OAK TREE RD
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-1044
Practice Address - Country:US
Practice Address - Phone:732-516-0707
Practice Address - Fax:732-516-0088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-09
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08231700207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty