Provider Demographics
NPI:1891795563
Name:SHAH, ANGANA NAYAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ANGANA
Middle Name:NAYAN
Last Name:SHAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANGANA
Other - Middle Name:NAYAN
Other - Last Name:PANDYA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1 CARDIFF CT
Mailing Address - Street 2:
Mailing Address - City:WEST WINDSOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08550-3268
Mailing Address - Country:US
Mailing Address - Phone:609-750-0875
Mailing Address - Fax:609-750-0875
Practice Address - Street 1:2999 PRINCETON PIKE
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-3261
Practice Address - Country:US
Practice Address - Phone:609-883-3000
Practice Address - Fax:609-423-0095
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD423809174400000X
NJ25MA07767800207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA081605Medicare ID - Type Unspecified
PAH67199Medicare UPIN