Provider Demographics
NPI:1073295879
Name:SHAH, SONALI (CRNP)
Entity type:Individual
Prefix:MISS
First Name:SONALI
Middle Name:
Last Name:SHAH
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 NEWMAN SPRINGS ROAD
Mailing Address - Street 2:BLDG. 2, SUITE 220
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701
Mailing Address - Country:US
Mailing Address - Phone:732-807-0877
Mailing Address - Fax:201-751-1680
Practice Address - Street 1:20 PROSPECT AVE STE 501
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1989
Practice Address - Country:US
Practice Address - Phone:551-996-0800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-02
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR247417363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care