Provider Demographics
NPI:1407388671
Name:AMIN, SHREYA (MD)
Entity Type:Individual
Prefix:DR
First Name:SHREYA
Middle Name:
Last Name:AMIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 GREEN HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:ISELIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08830-2921
Mailing Address - Country:US
Mailing Address - Phone:718-722-0197
Mailing Address - Fax:
Practice Address - Street 1:1021 PARK AVE STE 20
Practice Address - Street 2:
Practice Address - City:QUAKERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18951-0130
Practice Address - Country:US
Practice Address - Phone:215-538-4940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-28
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
VT06.0004959207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program