Provider Demographics
NPI:1336318344
Name:SHAH, VIRAL JAGDISHBHAI (MD)
Entity Type:Individual
Prefix:DR
First Name:VIRAL
Middle Name:JAGDISHBHAI
Last Name:SHAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:22 OLD SHORT HILLS RD STE 201
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-5605
Mailing Address - Country:US
Mailing Address - Phone:973-535-8870
Mailing Address - Fax:973-535-8818
Practice Address - Street 1:30 W CENTURY RD
Practice Address - Street 2:SUITE 255
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-1433
Practice Address - Country:US
Practice Address - Phone:973-535-8870
Practice Address - Fax:973-535-8818
Is Sole Proprietor?:No
Enumeration Date:2008-02-23
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT060-0003445207RE0101X
NY233395207RE0101X
NJ25MA083490000076207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism