Provider Demographics
NPI:1609046150
Name:ZIA H SHAH M.D.
Entity Type:Organization
Organization Name:ZIA H SHAH M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ZIA
Authorized Official - Middle Name:H
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:607-797-6363
Mailing Address - Street 1:161 RIVERSIDE DR STE M09
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13905-4112
Mailing Address - Country:US
Mailing Address - Phone:607-797-6363
Mailing Address - Fax:607-797-5487
Practice Address - Street 1:161 RIVERSIDE DR STE M09
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13905-4112
Practice Address - Country:US
Practice Address - Phone:607-797-6363
Practice Address - Fax:607-797-5487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-11
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY199773207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty