Provider Demographics
NPI:1063532034
Name:SHAH, RUPAL S (MD)
Entity type:Individual
Prefix:DR
First Name:RUPAL
Middle Name:S
Last Name:SHAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2758 BIRCH AVE
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-4325
Mailing Address - Country:US
Mailing Address - Phone:646-835-9733
Mailing Address - Fax:516-636-1204
Practice Address - Street 1:500 FRONT ST
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-4445
Practice Address - Country:US
Practice Address - Phone:516-636-1203
Practice Address - Fax:516-636-1204
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-31
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY241553207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine