Provider Demographics
NPI:1629009923
Name:SHAH, SAPNA R (DO)
Entity Type:Individual
Prefix:DR
First Name:SAPNA
Middle Name:R
Last Name:SHAH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:780 8TH AVE
Mailing Address - Street 2:SUITE 303
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-7000
Mailing Address - Country:US
Mailing Address - Phone:212-641-4500
Mailing Address - Fax:212-641-4508
Practice Address - Street 1:780 8TH AVE
Practice Address - Street 2:SUITE 303
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-7000
Practice Address - Country:US
Practice Address - Phone:212-641-4500
Practice Address - Fax:212-641-4508
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY216230207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH06614Medicare UPIN