Provider Demographics
NPI:1477308880
Name:SHAH, PURVA (MBBS)
Entity Type:Individual
Prefix:
First Name:PURVA
Middle Name:
Last Name:SHAH
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56-65 MAIN ST. NEW YORK-PRESBYTERIAN QUEENS
Mailing Address - Street 2:5TH FLOOR, ROOM S506
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355
Mailing Address - Country:US
Mailing Address - Phone:718-670-1347
Mailing Address - Fax:718-670-2456
Practice Address - Street 1:56-65 MAIN ST. NEW YORK-PRESBYTERIAN QUEENS
Practice Address - Street 2:5TH FLOOR, ROOM S506
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355
Practice Address - Country:US
Practice Address - Phone:718-670-1347
Practice Address - Fax:718-670-2456
Is Sole Proprietor?:No
Enumeration Date:2024-04-19
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program