Basic Information
| Provider Information | |||||||||
| NPI: | 1467913236 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHAH | ||||||||
| FirstName: | ROHAN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8605 60TH RD APT 6D | ||||||||
| Address2: | |||||||||
| City: | ELMHURST | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113735518 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3478374563 | ||||||||
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| Practice Location | |||||||||
| Address1: | DEPT OF MEDICINE HSC LEVEL 16, SUNY STONY BROOK HOSP | ||||||||
| Address2: | |||||||||
| City: | STONY BROOK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117940001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6314442058 | ||||||||
| FaxNumber: | 6314442493 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/26/2019 | ||||||||
| LastUpdateDate: | 08/19/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/17/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 316845 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.