Provider Demographics
NPI:1184811580
Name:SHAH, AMISHI (MD)
Entity type:Individual
Prefix:
First Name:AMISHI
Middle Name:
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 1:1010 CENTRAL PARK AVE
Mailing Address - Street 2:MONTEFIORE MEDICAL GROUP
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10704-1044
Mailing Address - Country:US
Mailing Address - Phone:914-964-4124
Mailing Address - Fax:914-964-4067
Practice Address - Street 1:1010 CENTRAL PARK AVE
Practice Address - Street 2:MONTEFIORE MEDICAL GROUP
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10704-1044
Practice Address - Country:US
Practice Address - Phone:914-964-4124
Practice Address - Fax:914-964-4067
Is Sole Proprietor?:No
Enumeration Date:2007-09-28
Last Update Date:2013-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY256700208000000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program