Provider Demographics
NPI:1750533733
Name:SHAH, NIRANJANA J (MD)
Entity type:Individual
Prefix:DR
First Name:NIRANJANA
Middle Name:J
Last Name:SHAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:NIRANJANA
Other - Middle Name:I
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6 CUMBERLAND DR
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-1652
Mailing Address - Country:US
Mailing Address - Phone:856-424-6353
Mailing Address - Fax:856-751-7609
Practice Address - Street 1:215 S BURLINGTON RD
Practice Address - Street 2:
Practice Address - City:BRIDGETON
Practice Address - State:NJ
Practice Address - Zip Code:08302-3479
Practice Address - Country:US
Practice Address - Phone:856-459-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ038854 MA207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine