Provider Demographics
NPI:1356217160
Name:SHAH PODIATRY PC
Entity type:Organization
Organization Name:SHAH PODIATRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SADIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:191-761-3162
Mailing Address - Street 1:1578 WILLIAMSBRIDGE RD APT 3A
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-6268
Mailing Address - Country:US
Mailing Address - Phone:347-270-5162
Mailing Address - Fax:347-270-5163
Practice Address - Street 1:1578 WILLIAMSBRIDGE RD APT 3A
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-6268
Practice Address - Country:US
Practice Address - Phone:347-270-5162
Practice Address - Fax:347-270-5163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-17
Last Update Date:2025-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty