Basic Information
| Provider Information | |||||||||
| NPI: | 1275500639 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHAH | ||||||||
| FirstName: | NEETA | ||||||||
| MiddleName: | S | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 630 PLANTATION STREET | ||||||||
| Address2: | |||||||||
| City: | WORCESTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01605 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5083683130 | ||||||||
| FaxNumber: | 5083683133 | ||||||||
| Practice Location | |||||||||
| Address1: | 340 THOMPSON ROAD | ||||||||
| Address2: | |||||||||
| City: | WEBSTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01570 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5083683130 | ||||||||
| FaxNumber: | 5083683133 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/03/2006 | ||||||||
| LastUpdateDate: | 02/25/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | 151182 | MA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | 042472266 | 01 | PRIVATE HEALTHCARE SYSTEM | OTHER | 784260 | 01 | MVP HEALTH CARE | OTHER | 5467617 | 01 | AETNA | OTHER | J17076 | 01 | BLUE CARE ELECT | OTHER | J17076 | 01 | BLUE SHIELD INDEMNITY | OTHER | 042472266 | 01 | ONE HEALTH PLAN | OTHER | 2501187 | 01 | EVERCARE | OTHER | 3156770 | 01 | WELFARE | OTHER | 53281 | 01 | CHILDRENS MEDICAL SECURIT | OTHER | 043058466 | 01 | HEALTHCARE VALUE MANAGEME | OTHER | 3156770 | 05 | MA | MEDICAID | 5467617 | 01 | US HEALTHCARE | OTHER | J17076 | 01 | BLUE SHIELD HMO BLUE | OTHER | 53281 | 01 | HEALTHY START | OTHER | 9319628 | 01 | CIGNA HEALTH PLAN | OTHER | 29826 | 01 | FIRST HEALTH | OTHER | AA2841 | 01 | HARVARD PILGRIM HEALTHCAR | OTHER |