Provider Demographics
NPI:1942414248
Name:SHAH, ROSHNI (RPA-C)
Entity Type:Individual
Prefix:
First Name:ROSHNI
Middle Name:
Last Name:SHAH
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:ROSHNI
Other - Middle Name:
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1771 UTICA AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-2120
Mailing Address - Country:US
Mailing Address - Phone:718-209-0888
Mailing Address - Fax:
Practice Address - Street 1:1771 UTICA AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-2120
Practice Address - Country:US
Practice Address - Phone:718-209-0888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009462363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant