Provider Demographics
NPI:1356627277
Name:SHAH, NRUPA (DPM)
Entity Type:Individual
Prefix:
First Name:NRUPA
Middle Name:
Last Name:SHAH
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2163 OAK TREE RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-1083
Mailing Address - Country:US
Mailing Address - Phone:732-662-3050
Mailing Address - Fax:732-662-3049
Practice Address - Street 1:2163 OAK TREE RD
Practice Address - Street 2:SUITE 108
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-1083
Practice Address - Country:US
Practice Address - Phone:732-662-3050
Practice Address - Fax:732-662-3049
Is Sole Proprietor?:No
Enumeration Date:2011-10-24
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
NJ25MD00311600213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program