Provider Demographics
NPI:1427011782
Name:SHAH, DHIREN K (MD)
Entity Type:Individual
Prefix:DR
First Name:DHIREN
Middle Name:K
Last Name:SHAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3085 HARLEM RD
Mailing Address - Street 2:SUITE 350
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14225-2591
Mailing Address - Country:US
Mailing Address - Phone:716-844-5500
Mailing Address - Fax:716-844-5550
Practice Address - Street 1:3085 HARLEM ROAD
Practice Address - Street 2:SUITE 100
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14225
Practice Address - Country:US
Practice Address - Phone:716-844-5500
Practice Address - Fax:716-844-5550
Is Sole Proprietor?:No
Enumeration Date:2006-04-08
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2004202085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00010162602OtherUNIVERA
NY3708711OtherINDEPENDENT HEALTH
NM000523855002OtherBC OF WNY
NY01619878Medicaid
NM000523855002OtherBC OF WNY
NYF894000Medicare UPIN