Provider Demographics
NPI:1386675585
Name:ZAMAN, SHAH M (MD)
Entity Type:Individual
Prefix:
First Name:SHAH
Middle Name:M
Last Name:ZAMAN
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 1:243 NORTH RD
Mailing Address - Street 2:SUITE 201S
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-1172
Mailing Address - Country:US
Mailing Address - Phone:845-473-5550
Mailing Address - Fax:845-473-1565
Practice Address - Street 1:243 NORTH RD
Practice Address - Street 2:SUITE 201S
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-1172
Practice Address - Country:US
Practice Address - Phone:845-473-5550
Practice Address - Fax:845-473-1565
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2014-12-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY141193207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00723726Medicaid
NYB18773Medicare UPIN
NY70A571Medicare ID - Type Unspecified