Kishori Shah, MD | |
40 Stirling Rd, Ste., 205, Watchung, NJ 07069-5900 | |
(908) 769-1084 | |
(908) 769-4139 |
Full Name | Kishori Shah |
---|---|
Gender | Female |
Speciality | Anesthesiology |
Location | 40 Stirling Rd, Watchung, New Jersey |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1225009111 | NPI | - | NPPES |
0176508 | Medicaid | NJ |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207L00000X | Anesthesiology | 02911000 (New Jersey) | Primary |
Entity Name | Olena Medical New Jersey Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1386180461 PECOS PAC ID: 6406123512 Enrollment ID: O20170522000198 |
Mailing Address | Practice Location Address |
---|---|
Kishori Shah, MD 40 Stirling Rd, Ste., 205, Watchung, NJ 07069-5900 Ph: (908) 769-1084 | Kishori Shah, MD 40 Stirling Rd, Ste., 205, Watchung, NJ 07069-5900 Ph: (908) 769-1084 |
Dr. Michael Vassallo, Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 40 Stirling Rd, Watchung, NJ 07069 Phone: 908-769-0912 | |
Rebecca A Varela, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 40 Stirling Rd, Watchung, NJ 07069 Phone: 908-803-4762 | |
Durgesh Mankikar, M.D. Anesthesiology Medicare: Medicare Enrolled Practice Location: 40 Stirling Rd, Ste., 205, Watchung, NJ 07069 Phone: 908-769-1084 Fax: 908-769-4139 |