Provider Demographics
NPI:1205250941
Name:UDAY N. SHAH, MD, PLLC
Entity type:Organization
Organization Name:UDAY N. SHAH, MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ZARNA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-603-0907
Mailing Address - Street 1:4112 JUDGE ST
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-2344
Mailing Address - Country:US
Mailing Address - Phone:718-779-6666
Mailing Address - Fax:718-651-3053
Practice Address - Street 1:4112 JUDGE ST
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-2344
Practice Address - Country:US
Practice Address - Phone:718-779-6666
Practice Address - Fax:718-651-3053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-18
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty