| Doctor Name: | SANJAYKUMAR SHAH |
| NPI Number: | 1083947279 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | APN |
| License Number: | 26NJ00228100 |
| Business Practice Address: | 15 White Birch Dr Morris Plains, NJ - 079503232 |
| Business Phone Number: | 9735381591 |
| Business Fax Number: | |
| Mailing Address: | 310 Central Ave Ste 102, EAST ORANGE |
| State: | NJ |
| Postal Code: | 070182838 |
| Phone Number: | 9733951550 |
| Fax Number: | |
| NPI Enumeration Date: | 09/07/2009 |
| NPI Last Update Date: | 06/24/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2100X |
| License Number: | 26NJ00228100 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Acute Care |
| Taxonomy Definition: | |