Provider Demographics
NPI:1467416388
Name:SHAH, BIPIN C (MD)
Entity Type:Individual
Prefix:
First Name:BIPIN
Middle Name:C
Last Name:SHAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7884 HIDDEN OAK
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-9612
Mailing Address - Country:US
Mailing Address - Phone:585-429-6190
Mailing Address - Fax:585-429-5945
Practice Address - Street 1:7884 HIDDEN OAK
Practice Address - Street 2:
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534
Practice Address - Country:US
Practice Address - Phone:585-429-6190
Practice Address - Fax:585-924-2540
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-17
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY131423207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYD78338Medicare UPIN
NY10296BMedicare ID - Type Unspecified