Provider Demographics
NPI:1669196721
Name:SHAH, SARAH J (DNP, APN, A-GNP-C)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:J
Last Name:SHAH
Suffix:
Gender:F
Credentials:DNP, APN, A-GNP-C
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:J
Other - Last Name:SONI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP, APN, A-GNP-C
Mailing Address - Street 1:127 CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-9402
Mailing Address - Country:US
Mailing Address - Phone:732-306-7290
Mailing Address - Fax:
Practice Address - Street 1:127 CHURCH RD
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-9402
Practice Address - Country:US
Practice Address - Phone:732-306-7290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-03
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01376900363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care