Provider Demographics
NPI:1811432545
Name:SHAH, SEEMA (PHD)
Entity type:Individual
Prefix:DR
First Name:SEEMA
Middle Name:
Last Name:SHAH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 ROOSEVELT RD
Mailing Address - Street 2:
Mailing Address - City:CHATHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:07928-1178
Mailing Address - Country:US
Mailing Address - Phone:908-917-1008
Mailing Address - Fax:
Practice Address - Street 1:20 ROOSEVELT RD
Practice Address - Street 2:
Practice Address - City:CHATHAM
Practice Address - State:NJ
Practice Address - Zip Code:07928-1178
Practice Address - Country:US
Practice Address - Phone:908-917-1008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-04
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00402400103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical