Provider Demographics
NPI:1811103567
Name:SHAH, ASHA D (MD)
Entity type:Individual
Prefix:
First Name:ASHA
Middle Name:D
Last Name:SHAH
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:377 JERSEY AVE
Mailing Address - Street 2:SUITE 280
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-4393
Mailing Address - Country:US
Mailing Address - Phone:201-915-2450
Mailing Address - Fax:201-915-2192
Practice Address - Street 1:377 JERSEY AVE
Practice Address - Street 2:SUITE 280
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-4393
Practice Address - Country:US
Practice Address - Phone:201-915-2450
Practice Address - Fax:201-915-2192
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2015-01-12
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA09201400208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology