Shah, Madhavi

Shah, Madhavi is an individual health care provider with primary practice located at 199 Broad Street Suite 1B, Bloomfield NJ 07003. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Adolescent Medicine. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Shah, Madhavi can be contacted via phone (973) 743-1392.

Contact Information

Primary practice address
199 Broad Street Suite 1B Bloomfield NJ 07003
Phone: (973) 743-1392
Fax: (973) 743-3707
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MA041063 New Jersey
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X MAO41063 New Jersey

Profile Details

NPI number 1316059033
LBN Legal business name Shah, Madhavi
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316059033 NPPES
New Jersey MEDICAID 1045504

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