Provider Demographics
NPI:1346439213
Name:SHAH, SUMIT P (MD)
Entity Type:Individual
Prefix:DR
First Name:SUMIT
Middle Name:P
Last Name:SHAH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1000 GALLOPING HILL RD
Mailing Address - Street 2:SUITE 305
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-7989
Mailing Address - Country:US
Mailing Address - Phone:908-458-8330
Mailing Address - Fax:
Practice Address - Street 1:10 PLUM ST
Practice Address - Street 2:SUITE 600
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-2065
Practice Address - Country:US
Practice Address - Phone:732-220-1600
Practice Address - Fax:732-220-1603
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-17
Last Update Date:2017-08-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA09260500207WX0107X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology