Provider Demographics
NPI:1811468242
Name:SHAH, AMI V (PSYD)
Entity type:Individual
Prefix:DR
First Name:AMI
Middle Name:V
Last Name:SHAH
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:418 E 71ST ST PH FLOOR
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4894
Mailing Address - Country:US
Mailing Address - Phone:212-535-8932
Mailing Address - Fax:212-535-5443
Practice Address - Street 1:418 E 71ST ST FL PH
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4892
Practice Address - Country:US
Practice Address - Phone:212-535-8932
Practice Address - Fax:212-535-5443
Is Sole Proprietor?:No
Enumeration Date:2018-12-11
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023026103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical