Provider Demographics
NPI:1861628158
Name:SHAH, AMI (PHD)
Entity Type:Individual
Prefix:DR
First Name:AMI
Middle Name:
Last Name:SHAH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:853 BROADWAY STE 1603
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-4714
Mailing Address - Country:US
Mailing Address - Phone:917-428-0562
Mailing Address - Fax:
Practice Address - Street 1:853 BROADWAY STE 1603
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-4714
Practice Address - Country:US
Practice Address - Phone:917-428-0562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-01
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health