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1487727996
JITENDRA A SHAH
PATCHOGUE, NY
NPI
1487727996
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207Q00000X Family Medicine
(Licence: NY 124768-1)
Enumeration Date
2006-11-15
Last Update Date
2007-07-08
Business Address
Dr. JITENDRA A SHAH M.D.
504 MEDFORD AVE
PATCHOGUE, NY 11772-1321
Phone number: 631-475-4646
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Mailing Address
Dr. JITENDRA A SHAH M.D.
504 MEDFORD AVE
PATCHOGUE, NY 11772-1321
Phone number: 631-475-4646
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