Provider Demographics
NPI:1518016583
Name:SHAH, HIMANSHU ARVINDLAL (RPH)
Entity Type:Individual
Prefix:MR
First Name:HIMANSHU
Middle Name:ARVINDLAL
Last Name:SHAH
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 N 1ST ST
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-2838
Mailing Address - Country:US
Mailing Address - Phone:516-775-5828
Mailing Address - Fax:516-775-5828
Practice Address - Street 1:1560 GRAND CONCOURSE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-8402
Practice Address - Country:US
Practice Address - Phone:718-294-7899
Practice Address - Fax:718-294-7506
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY040713183500000X
FLPS29824183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist