Provider Demographics
NPI:1790588523
Name:SHAH, SAHIL
Entity type:Individual
Prefix:
First Name:SAHIL
Middle Name:
Last Name:SHAH
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 SPRINGFIELD RD
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-4563
Mailing Address - Country:US
Mailing Address - Phone:732-599-4473
Mailing Address - Fax:
Practice Address - Street 1:74 SPRINGFIELD RD
Practice Address - Street 2:
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-4563
Practice Address - Country:US
Practice Address - Phone:732-599-4473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-28
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program