| Rajiv S Shah Physician P C | |
|
5 Clay St Malone NY 12953-1905 | |
| (518) 483-0705 | |
| (518) 483-1375 |
| Full Name | Rajiv S Shah Physician P C |
|---|---|
| Speciality | Internal Medicine |
| Location | 5 Clay St, Malone, New York |
| Authorized Official Name and Position | Rajiv Shah (SOLE MEMBER) |
| Authorized Official Contact | 5184830705 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rajiv S Shah Physician P C Po Box 2337 Syracuse NY 13220-2337 Ph: (315) 422-2933 | Rajiv S Shah Physician P C 5 Clay St Malone NY 12953-1905 Ph: (518) 483-0705 |
| NPI Number | 1457428559 |
|---|---|
| Provider Enumeration Date | 11/30/2006 |
| Last Update Date | 11/23/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457428559 | NPI | - | NPPES |
| DF8170 | Other | NY | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 168997 (New York) | Primary |
| 207RG0100X | Internal Medicine - Gastroenterology | 168997 (New York) | Secondary |
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