Shrenik G Shah MD PC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

MA044420 Issued in NJ

Legal business name

SHRENIK G SHAH MD PC

Practice address

55 W Passaic Ave
Bloomfield, NJ 07003-4502

Phone

(973) 338-8059

Fax

(973) 338-6013

NPI assigned

Sep 27, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Shrenik G Shah, MD

Title

Doctor

Phone

(973) 338-8059

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1380240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380499200000",
    "number": "1922435585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 W PASSAIC AVE",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070034502",
            "telephone_number": "973-338-8059",
            "fax_number": "973-338-6013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 W PASSAIC AVE",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070034502",
            "telephone_number": "973-338-8059",
            "fax_number": "973-338-6013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHRENIK G SHAH MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-27",
        "last_updated": "2013-09-30",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "SHRENIK",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "973-338-8059",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NJ",
            "license": "MA044420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4699106",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Shahbandi, MD
• Amanda Shaw
• Saty Hemdan Sherif, RPH
• Nima Nuru Sherpa
• Allison Sherwood, APN
• Shreya Mehta DPM, PA
• Garry Shtofmakher, DPM
• Kateryna Serhiyivna Shushval, LPC
• Ronald A Silver, DDS
• Mingi Nicole Sim

• Primary Care Clinic/Center in Bloomfield, NJ
• Providers in Bloomfield, NJ by specialty
• Primary Care Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2013; 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.