Provider Demographics
NPI:1992137558
Name:SHAH, RUSHI H (PHARMD)
Entity type:Individual
Prefix:MR
First Name:RUSHI
Middle Name:H
Last Name:SHAH
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 N MAIN ST
Mailing Address - Street 2:APT 6A
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-3802
Mailing Address - Country:US
Mailing Address - Phone:845-532-6372
Mailing Address - Fax:
Practice Address - Street 1:4120 PALISADES CENTER DR
Practice Address - Street 2:
Practice Address - City:WEST NYACK
Practice Address - State:NY
Practice Address - Zip Code:10994-6801
Practice Address - Country:US
Practice Address - Phone:845-532-6378
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-06
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY058285183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist