Sudha R Shah MD PC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

133672 Issued in NY

Legal business name

SUDHA R SHAH MD PC

Practice address

3860 Kings Hwy
#1
Brooklyn, NY 11234-2907

Phone

(718) 252-5550

Fax

(718) 258-1768

NPI assigned

Dec 20, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Sudha R Shah, M.D.

Title

President

Phone

(718) 252-5550

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1324339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328572800000",
    "number": "1164791190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3860 KINGS HWY",
            "address_2": "#1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112342907",
            "telephone_number": "718-252-5550",
            "fax_number": "718-258-1768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3860 KINGS HWY",
            "address_2": "#1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112342907",
            "telephone_number": "718-252-5550",
            "fax_number": "718-258-1768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUDHA R SHAH MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-20",
        "last_updated": "2012-02-07",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "SUDHA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-252-5550",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NY",
            "license": "133672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00346814",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sudara PT PC
• Rahat Nawaz Suddle, MD
• Gayathri Sudha Hari, M.D.
• Sudha Patel MD PLLC (Sudha Patel M.D.)
• Sudha Patel MD PLLC
• Elisabeth Jean Sudiker
• Bruno Marius Suditu, PA
• Kenay Magdalene Sudler, M.S. CCC-SLP
• Shanece Sudlow, THERAPIST
• Sharon Sudman-O'Neill, M.S.ED, SAS, SDA

• Primary Care Clinic/Center in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Primary Care Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.