Provider Demographics
NPI:1851134688
Name:SHAH, VEDANT BHAVESHBHAI
Entity type:Individual
Prefix:
First Name:VEDANT
Middle Name:BHAVESHBHAI
Last Name:SHAH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 POCONO ROAD ST CLARE'S HEALTH DENVILE HOSPITAL
Mailing Address - Street 2:
Mailing Address - City:DENVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07834
Mailing Address - Country:US
Mailing Address - Phone:201-275-6884
Mailing Address - Fax:
Practice Address - Street 1:25 POCONO ROAD ST CLARE'S HEALTH DENVILE HOSPITAL
Practice Address - Street 2:
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834
Practice Address - Country:US
Practice Address - Phone:201-275-6884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-18
Last Update Date:2025-02-10
Deactivation Date:2025-01-31
Deactivation Code:
Reactivation Date:2025-02-10
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program