Provider Demographics
NPI:1528861309
Name:SHAH, ANKITA S
Entity type:Individual
Prefix:
First Name:ANKITA
Middle Name:S
Last Name:SHAH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 ELIZABETH AVE
Mailing Address - Street 2:
Mailing Address - City:ISELIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08830-2260
Mailing Address - Country:US
Mailing Address - Phone:732-512-7783
Mailing Address - Fax:732-582-5501
Practice Address - Street 1:33 WOOD AVE S UNIT 436
Practice Address - Street 2:
Practice Address - City:ISELIN
Practice Address - State:NJ
Practice Address - Zip Code:08830-2735
Practice Address - Country:US
Practice Address - Phone:732-512-7783
Practice Address - Fax:732-582-5501
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-28
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0306200251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health