Provider Demographics
NPI:1982003679
Name:SHAH, RASHESH M (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:RASHESH
Middle Name:M
Last Name:SHAH
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6360 98TH ST
Mailing Address - Street 2:E05
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-2238
Mailing Address - Country:US
Mailing Address - Phone:718-453-6200
Mailing Address - Fax:
Practice Address - Street 1:1436 MYRTLE AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11237-5102
Practice Address - Country:US
Practice Address - Phone:718-453-6200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-19
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY059547183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY059547OtherLICENSE NUMBER