Provider Demographics
NPI:1790970069
Name:SHAH, LILY H (MD)
Entity Type:Individual
Prefix:
First Name:LILY
Middle Name:H
Last Name:SHAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LILY
Other - Middle Name:H
Other - Last Name:HONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3912 TRINDLE ROAD
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-4246
Mailing Address - Country:US
Mailing Address - Phone:717-761-8740
Mailing Address - Fax:717-761-8792
Practice Address - Street 1:3912 TRINDLE ROAD
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-4246
Practice Address - Country:US
Practice Address - Phone:717-761-8740
Practice Address - Fax:717-761-8792
Is Sole Proprietor?:No
Enumeration Date:2007-09-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD432515207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0009855260006Medicaid
PA10256572000001Medicaid
PA10256572000001Medicaid
PA10256572000001Medicaid