Provider Demographics
NPI:1104499615
Name:RITA SHAH INFECTIOUS DISEASE PLLC
Entity type:Organization
Organization Name:RITA SHAH INFECTIOUS DISEASE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:RITA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:347-724-1994
Mailing Address - Street 1:312 PROUD EAGLE LN # 89144
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89144-0808
Mailing Address - Country:US
Mailing Address - Phone:702-818-9397
Mailing Address - Fax:702-710-0850
Practice Address - Street 1:312 PROUD EAGLE LN # 89144
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89144-0808
Practice Address - Country:US
Practice Address - Phone:702-818-9397
Practice Address - Fax:702-710-0850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-22
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious DiseasesGroup - Single Specialty