Shah, Ketan D.

Shah, Ketan D. is an individual health care provider with primary practice located at 9234 Kennedy Blvd , North Bergen NJ 07047-5312. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as his primary health care specialty. Shah, Ketan D. can be contacted via phone (201) 868-2400.

Contact Information

Primary practice address
9234 Kennedy Blvd North Bergen NJ 07047-5312
Phone: (201) 868-2400
Fax: (201) 868-2014
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 25MD00270100 New Jersey

Profile Details

NPI number 1609822360
LBN Legal business name Shah, Ketan D.
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date May 25th, 2006
Last updated Mar 31st, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609822360 NPPES
New Jersey MEDICAID 8882401

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