Provider Demographics
NPI:1689858425
Name:SHAH, SACHIN N (MD)
Entity Type:Individual
Prefix:DR
First Name:SACHIN
Middle Name:N
Last Name:SHAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MERRICK RD
Mailing Address - Street 2:SUITE128W
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-4800
Mailing Address - Country:US
Mailing Address - Phone:516-255-9031
Mailing Address - Fax:
Practice Address - Street 1:100 MERRICK RD
Practice Address - Street 2:SUITE 128W
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-4800
Practice Address - Country:US
Practice Address - Phone:516-255-9031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-27
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY260301207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery