Provider Demographics
NPI:1871184960
Name:SHAH, ANKUR
Entity Type:Individual
Prefix:
First Name:ANKUR
Middle Name:
Last Name:SHAH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 PRINCETON HIGHLANDS BLVD
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-8588
Mailing Address - Country:US
Mailing Address - Phone:908-494-3916
Mailing Address - Fax:
Practice Address - Street 1:2853 WOODBRIDGE AVE
Practice Address - Street 2:SUITE 8
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08837-0883
Practice Address - Country:US
Practice Address - Phone:732-605-4307
Practice Address - Fax:732-605-4308
Is Sole Proprietor?:No
Enumeration Date:2021-02-01
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP451363183500000X
NJ28RI03358200183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist