Provider Demographics
NPI:1376204750
Name:DR AMI SHAH PSYCHOLOGY PC
Entity Type:Organization
Organization Name:DR AMI SHAH PSYCHOLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AMI
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:201-247-2663
Mailing Address - Street 1:68 BIRCH HL
Mailing Address - Street 2:
Mailing Address - City:ALBERTSON
Mailing Address - State:NY
Mailing Address - Zip Code:11507-1002
Mailing Address - Country:US
Mailing Address - Phone:201-247-2663
Mailing Address - Fax:
Practice Address - Street 1:68 BIRCH HL
Practice Address - Street 2:
Practice Address - City:ALBERTSON
Practice Address - State:NY
Practice Address - Zip Code:11507-1002
Practice Address - Country:US
Practice Address - Phone:201-247-2663
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-06
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty