Most Relevant Information
Provider Data
| NPI Number: | 1003201179 |
| Provider Name: | POOJA R SHAH MD |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/05/2015 |
| Last Updated: | 01/17/2021 |
Provider Practice Location
177 MAIN ST STE 105
HUNTINGTON
NY
11743
Practice Location Phone/Fax
| Phone: | 6314214188 |
| Fax: |
Provider Mailing Location
177 MAIN ST STE 105
HUNTINGTON
NY
117436917
Provider Mailing Phone/Fax
| Phone: | 6314214188 |
| Fax: |