Provider Demographics
NPI:1720425770
Name:N K SHAH MEDICAL PC
Entity type:Organization
Organization Name:N K SHAH MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NIMESH
Authorized Official - Middle Name:K
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-464-6700
Mailing Address - Street 1:20507 HILLSIDE AVE STE 12
Mailing Address - Street 2:
Mailing Address - City:HOLLIS
Mailing Address - State:NY
Mailing Address - Zip Code:11423-2220
Mailing Address - Country:US
Mailing Address - Phone:718-464-6700
Mailing Address - Fax:718-464-8100
Practice Address - Street 1:20507 HILLSIDE AVE STE 12
Practice Address - Street 2:
Practice Address - City:HOLLIS
Practice Address - State:NY
Practice Address - Zip Code:11423-2220
Practice Address - Country:US
Practice Address - Phone:718-464-6700
Practice Address - Fax:718-464-8100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-31
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty