Rajiv S Shah Physician P C

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

168997 Issued in NY

Legal business name

RAJIV S SHAH PHYSICIAN P C

Practice address

5 Clay St
Malone, NY 12953-1905

Phone

(518) 483-0705

Fax

(518) 483-1375

NPI assigned

Nov 30, 2006

Organization subpart

No

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

Authorized official

Name

Rajiv Shah, MD

Title

Sole Member

Phone

(518) 483-0705

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195776000000",
    "number": "1457428559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2337",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132202337",
            "telephone_number": "315-422-2933",
            "fax_number": "315-422-3909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 CLAY ST",
            "city": "MALONE",
            "state": "NY",
            "postal_code": "129531905",
            "telephone_number": "518-483-0705",
            "fax_number": "518-483-1375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAJIV S SHAH PHYSICIAN P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2007-11-23",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "RAJIV",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "518-483-0705",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "168997",
            "primary": true
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "168997",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DF8170",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bridget Jaylene Rabideau
• Kyle Giles Rabideau, PHARMD
• Michelle Marie Rabideau
• Norma Alice Race, R.N.
• Dorene Raimondo
• Beth Szymoniak Randall, OTR
• Crystal Raville, RN
• Marcia J Raville, LCSW-R
• Samantha Reagan
• Heather Marie Recore

• Internal Medicine Physician in Malone, NY
• Providers in Malone, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2007; 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.