| Rajan Shah Md Pa | |
|
1060 Broad St Newark NJ 07102-2397 | |
| (973) 642-0280 | |
| (973) 642-0047 |
| Full Name | Rajan Shah Md Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 1060 Broad St, Newark, New Jersey |
| Authorized Official Name and Position | Rajan S Shah (PRESIDENT) |
| Authorized Official Contact | 9736420280 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rajan Shah Md Pa 95 Falcon Rd Livingston NJ 07039-4427 Ph: (973) 642-0280 | Rajan Shah Md Pa 1060 Broad St Newark NJ 07102-2397 Ph: (973) 642-0280 |
| NPI Number | 1265627376 |
|---|---|
| Provider Enumeration Date | 09/11/2007 |
| Last Update Date | 09/11/2007 |
| Medicare PECOS PAC ID | 8921048356 |
|---|---|
| Medicare Enrollment ID | O20050505000283 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265627376 | NPI | - | NPPES |
| 0560901 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | MA40413 (New Jersey) | Primary |
| Provider Name | Rajan Shah |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1356378434 PECOS PAC ID: 7911947346 Enrollment ID: I20050505000306 |
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