Provider Demographics
NPI:1861178725
Name:SHAH, NAND (OD)
Entity type:Individual
Prefix:
First Name:NAND
Middle Name:
Last Name:SHAH
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5293 COVINGTON MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082
Mailing Address - Country:US
Mailing Address - Phone:614-390-1475
Mailing Address - Fax:
Practice Address - Street 1:1797 PITKIN AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212-7839
Practice Address - Country:US
Practice Address - Phone:718-971-1944
Practice Address - Fax:718-971-1945
Is Sole Proprietor?:No
Enumeration Date:2023-06-26
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009829152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist