Provider Demographics
NPI:1558680322
Name:SHAH, RAE ANN (CRNA)
Entity Type:Individual
Prefix:
First Name:RAE
Middle Name:ANN
Last Name:SHAH
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:RAE
Other - Middle Name:ANN
Other - Last Name:ASTFALK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:4800 FRIENDSHIP AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15224-1722
Mailing Address - Country:US
Mailing Address - Phone:412-578-5323
Mailing Address - Fax:412-605-6425
Practice Address - Street 1:4800 FRIENDSHIP AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-1722
Practice Address - Country:US
Practice Address - Phone:412-578-5323
Practice Address - Fax:412-605-6425
Is Sole Proprietor?:No
Enumeration Date:2010-05-19
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN546259367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered