NAMITHA JOHN SHAH


Address: 1619 Broadway, New York, NY 10019-7412
Phone: 6464165752

NAMITHA JOHN SHAH (NPI# 1235620048) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1235620048
Entity Type Individual
Full Name NAMITHA JOHN SHAH
Credential FNP-BC
Practice Address 1619 Broadway
New York
NY 10019-7412
Mailing Address 30 N Tyson Ave
Floral Park
NY 11001-1515
Practice Telephone 6464165752
Mailing Telephone 3476248566
Enumeration Date 2018-05-29
Last Update Date 2020-10-22
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LF0000X Nurse Practitioner
Specialization: Family
342753 NY Physician Assistants & Advanced Practice Nursing Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
8781 169th St, Jamaica, NY 114324438 7182062400

Office Location

Street Address 1619 BROADWAY
City NEW YORK
State NY
Zip Code 10019-7412

Providers in the same location

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1396386504 Susan Zhao Pharmacist 1619 Broadway, New York, NY 10019-7412 2019-09-30
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NPI Name Taxonomy Address Enumeration
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1558823070 Nazanin Khajoueinejad Student in an Organized Health Care Education/Training Program 425 West 59th Street, 7th Floor, Department of Surgery, New York, NY 10019 2019-04-03
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1043784804 Dr Rosemarie Zimmerman & Dr Andriy Krayniy Pllc Dentist 135 West 58 Street, Suite 1d, Nyc, NY 10019 2019-01-15
1053881680 Mary Pender Greene Social Worker 311a West 50 Street, New York, NY 10019 2018-11-27
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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

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1407462492 Alexandra Moench Nurse Practitioner 225 W 23rd St Apt 5s, New York, NY 10011-2300 2020-09-16
1770193237 Lenka Varekova Nurse Practitioner 242 E 5th St Apt 3, New York, NY 10003-8501 2020-08-08
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1366061376 Christine Go Np In Family Health PC Nurse Practitioner 315 Madison Ave Ste 1200, New York, NY 10017-5441 2020-04-09
1427687151 Ken Chuan Michael Chan Nurse Practitioner 110 Madison Ave Apt 10, New York, NY 10016-7486 2020-04-04
1528695004 Marylee Ann Marre Nurse Practitioner 226 E 25th St Apt 3d, New York, NY 10010 2020-03-25
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Competitor

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City NEW YORK
Zip Code 10019

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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