Provider Demographics
NPI:1134168776
Name:SHAH, PARESHA S (MD)
Entity type:Individual
Prefix:
First Name:PARESHA
Middle Name:S
Last Name:SHAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:860 ROUTE 168
Mailing Address - Street 2:SUITE 206
Mailing Address - City:TURNERSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08012-3215
Mailing Address - Country:US
Mailing Address - Phone:856-227-5700
Mailing Address - Fax:856-227-9800
Practice Address - Street 1:860 ROUTE 168
Practice Address - Street 2:SUITE 206
Practice Address - City:TURNERSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08012-3215
Practice Address - Country:US
Practice Address - Phone:856-227-5700
Practice Address - Fax:856-227-9800
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA50402207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1264907Medicaid
NJC33968Medicare UPIN
NJ607309Medicare PIN