| Shah Primary Care | |
|
1680 Rte 23 Ste 160 Wayne NJ 07470-7512 | |
| (973) 221-2500 | |
| Not Available |
| Full Name | Shah Primary Care |
|---|---|
| Speciality | Internal Medicine |
| Location | 1680 Rte 23 Ste 160, Wayne, New Jersey |
| Authorized Official Name and Position | Shipra Shah (OWNER) |
| Authorized Official Contact | 9732212500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shah Primary Care 1680 Rte 23 Ste 160 Wayne NJ 07470-7512 Ph: (973) 221-2500 | Shah Primary Care 1680 Rte 23 Ste 160 Wayne NJ 07470-7512 Ph: (973) 221-2500 |
| NPI Number | 1750056644 |
|---|---|
| Provider Enumeration Date | 08/12/2021 |
| Last Update Date | 08/16/2021 |
| Certification Date | 08/16/2021 |
| Medicare PECOS PAC ID | 7012312481 |
|---|---|
| Medicare Enrollment ID | O20210823002705 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750056644 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Deepa Rajiv |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891808390 PECOS PAC ID: 0840296190 Enrollment ID: I20090624000167 |
| Provider Name | Shipra Shah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154689156 PECOS PAC ID: 3476868407 Enrollment ID: I20150819008276 |
| Provider Name | Priya Patel |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1750127312 PECOS PAC ID: 2264972850 Enrollment ID: I20240910002631 |
| Provider Name | Shih Hua Fu |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1821818196 PECOS PAC ID: 1254857600 Enrollment ID: I20250429000748 |
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