Provider Demographics
NPI:1194258343
Name:SHAH, LEENA Y (MD)
Entity type:Individual
Prefix:DR
First Name:LEENA
Middle Name:Y
Last Name:SHAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 SOUTH ST STE 340
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-6473
Mailing Address - Country:US
Mailing Address - Phone:973-971-4599
Mailing Address - Fax:973-290-2383
Practice Address - Street 1:435 SOUTH ST STE 340
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-6473
Practice Address - Country:US
Practice Address - Phone:973-971-4599
Practice Address - Fax:973-290-2383
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-05
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY303701207R00000X
390200000X
NJ25MA11443300207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program