Provider Demographics
NPI:1376819094
Name:SHAH, HEMANG K (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:HEMANG
Middle Name:K
Last Name:SHAH
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2235 SPRINGFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:VAUXHALL
Mailing Address - State:NJ
Mailing Address - Zip Code:07088-1100
Mailing Address - Country:US
Mailing Address - Phone:908-622-9003
Mailing Address - Fax:908-622-9013
Practice Address - Street 1:2235 SPRINGFIELD AVE
Practice Address - Street 2:
Practice Address - City:VAUXHALL
Practice Address - State:NJ
Practice Address - Zip Code:07088-1100
Practice Address - Country:US
Practice Address - Phone:908-622-9003
Practice Address - Fax:908-622-9013
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-27
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03442500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist