Basic Information
| Provider Information | |||||||||
| NPI: | 1427122084 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHAH | ||||||||
| FirstName: | ASMA | ||||||||
| MiddleName: | AFTAB | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 218A SUNSET RD | ||||||||
| Address2: | LOURDES MEDICAL CENTER OF BURLINGTON CO. | ||||||||
| City: | WILLINGBORO | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080461110 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6098352900 | ||||||||
| FaxNumber: | 8565666906 | ||||||||
| Practice Location | |||||||||
| Address1: | 218A SUNSET RD | ||||||||
| Address2: | LOURDES MEDICAL CENTER OF BURLINGTON CO. | ||||||||
| City: | WILLINGBORO | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080461110 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6098352900 | ||||||||
| FaxNumber: | 8565666906 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/17/2006 | ||||||||
| LastUpdateDate: | 11/17/2011 | ||||||||
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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 | 207R00000X | 04-32290 | KS | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 25MA08856200 | NJ | Y | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | 25MA08856200 | NJ | N | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 200450410A | 05 | KS | MEDICAID | 106623 | 01 | KS | MEDICARE | OTHER |