Provider Demographics
NPI:1407998784
Name:SHAH, NRUPA (MD)
Entity Type:Individual
Prefix:DR
First Name:NRUPA
Middle Name:
Last Name:SHAH
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 1:14 RICHLAND DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-9610
Mailing Address - Country:US
Mailing Address - Phone:856-787-1840
Mailing Address - Fax:856-778-5676
Practice Address - Street 1:601 HAMILTON AVE
Practice Address - Street 2:SAINT FRANCIS MEDICAL CENTER- DEPARTMENT OF MEDICINE
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08629-1915
Practice Address - Country:US
Practice Address - Phone:609-599-5000
Practice Address - Fax:609-599-6232
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA70200207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8349908Medicaid
NJH18324Medicare UPIN
NJ8349908Medicaid