Provider Demographics
NPI:1477547446
Name:SHAH, ANITA CHATLANI (MD)
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:CHATLANI
Last Name:SHAH
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:20 GRAND STREET
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:WARWICK
Mailing Address - State:NY
Mailing Address - Zip Code:10990-1035
Mailing Address - Country:US
Mailing Address - Phone:845-353-5600
Mailing Address - Fax:845-987-5979
Practice Address - Street 1:2 CROSFIELD AVE
Practice Address - Street 2:STE 318
Practice Address - City:WEST NYACK
Practice Address - State:NY
Practice Address - Zip Code:10994-2226
Practice Address - Country:US
Practice Address - Phone:845-353-5600
Practice Address - Fax:845-353-5668
Is Sole Proprietor?:No
Enumeration Date:2005-09-07
Last Update Date:2019-01-03
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Provider Licenses
StateLicense IDTaxonomies
NY2156351207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
132995699OtherHUDSON HEALTH PLAN
132995699OtherMAGNACARE
215635OtherLICENSE NUMBER
015AE1OtherBC BS EMPIRE
NY02200755Medicaid
0D2175OtherHEALTHNET OF THE NORTH EA
132995699OtherHEALTH NOW
132995699OtherHORIZON HEALTHCARE OF NY
2594362OtherGHI
0057864OtherGHI HMO
45022POtherHIP
132995699OtherINDECS
040426012111OtherFIDELIS MEDICAID HMO
0890100002OtherCIGNA HMO POS
132995699OtherBEECH STREET NETWORK
132995699OtherLOCAL 1199
132995699OtherCIGNA PPO
132995699OtherFAM HEALTH PLUS HUDSON HP
132995699OtherHORIZON HEALTHCARE OF NY
132995699OtherLOCAL 1199