| Sudha R Shah Md Pc | |
|
3860 Kings Hwy #1 Brooklyn NY 11234-2907 | |
| (718) 252-5550 | |
| (718) 258-1768 |
| Full Name | Sudha R Shah Md Pc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 3860 Kings Hwy, Brooklyn, New York |
| Authorized Official Name and Position | Sudha R Shah (PRESIDENT) |
| Authorized Official Contact | 7182525550 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sudha R Shah Md Pc 3860 Kings Hwy #1 Brooklyn NY 11234-2907 Ph: (718) 252-5550 | Sudha R Shah Md Pc 3860 Kings Hwy #1 Brooklyn NY 11234-2907 Ph: (718) 252-5550 |
| NPI Number | 1164791190 |
|---|---|
| Provider Enumeration Date | 12/20/2011 |
| Last Update Date | 02/07/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164791190 | NPI | - | NPPES |
| 00346814 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 133672 (New York) | Primary |
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