Provider Demographics
NPI:1558788935
Name:SHAH, TRISHA (MD)
Entity Type:Individual
Prefix:MRS
First Name:TRISHA
Middle Name:
Last Name:SHAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TRISHA
Other - Middle Name:
Other - Last Name:KADAKIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:141 S. CENTRAL AVE, MONTEFIORE MEDICAL CENTER
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HARTSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10530-2319
Mailing Address - Country:US
Mailing Address - Phone:914-997-1060
Mailing Address - Fax:
Practice Address - Street 1:141 S. CENTRAL AVE, MONTEFIORE MEDICAL CENTER
Practice Address - Street 2:SUITE 201
Practice Address - City:HARTSDALE
Practice Address - State:NY
Practice Address - Zip Code:10530-2319
Practice Address - Country:US
Practice Address - Phone:914-997-1060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-24
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY293064207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program