Provider Demographics
NPI:1982703500
Name:SHAH, TALAXI D (MD)
Entity Type:Individual
Prefix:DR
First Name:TALAXI
Middle Name:D
Last Name:SHAH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:33 OVERLOOK ROAD
Mailing Address - Street 2:SUITE 404
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901
Mailing Address - Country:US
Mailing Address - Phone:908-522-3099
Mailing Address - Fax:908-522-3299
Practice Address - Street 1:33 OVERLOOK ROAD
Practice Address - Street 2:SUITE 404
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901
Practice Address - Country:US
Practice Address - Phone:908-522-3099
Practice Address - Fax:908-522-3299
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ260792084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
SH193905Medicare ID - Type Unspecified
D06297Medicare UPIN