Provider Demographics
NPI:1588037220
Name:SHAH, BILAL (DC)
Entity Type:Individual
Prefix:DR
First Name:BILAL
Middle Name:
Last Name:SHAH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 AUDUBON AVE
Mailing Address - Street 2:440 AUDOBON AVE
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10040-4502
Mailing Address - Country:US
Mailing Address - Phone:212-795-0282
Mailing Address - Fax:
Practice Address - Street 1:440 AUDUBON AVE
Practice Address - Street 2:440 AUDOBON AVE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10040-4502
Practice Address - Country:US
Practice Address - Phone:212-795-0282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-03
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012711111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor