Provider Demographics
NPI:1407546401
Name:SHAH, AMY KIRAN (MS CF-SLP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:KIRAN
Last Name:SHAH
Suffix:
Gender:F
Credentials:MS CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 W 52ND ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-5074
Mailing Address - Country:US
Mailing Address - Phone:972-974-2900
Mailing Address - Fax:
Practice Address - Street 1:525 W 52ND ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-5074
Practice Address - Country:US
Practice Address - Phone:972-974-2900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-11
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty