Provider Demographics
NPI:1396773933
Name:KAPOOR, RINA SHAH (MD)
Entity type:Individual
Prefix:DR
First Name:RINA
Middle Name:SHAH
Last Name:KAPOOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:RINA
Other - Middle Name:
Other - Last Name:SHAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1786 WILMINGTON W CHESTER PIKE STE 100A
Mailing Address - Street 2:
Mailing Address - City:GLEN MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19342-8199
Mailing Address - Country:US
Mailing Address - Phone:201-424-9025
Mailing Address - Fax:
Practice Address - Street 1:1786 WILMINGTON W CHESTER PIKE STE 100A
Practice Address - Street 2:
Practice Address - City:GLEN MILLS
Practice Address - State:PA
Practice Address - Zip Code:19342-8199
Practice Address - Country:US
Practice Address - Phone:201-424-9025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD426257207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAI55456Medicare UPIN
PA102224Medicare PIN