Shah, Lisa Jitendra

Shah, Lisa Jitendra is an individual health care provider with primary practice located at 321 W Girard Ave , Philadelphia PA 19123-1531. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Adult Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Shah, Lisa Jitendra can be contacted via phone (215) 685-3808.

Contact Information

Primary practice address
321 W Girard Ave Philadelphia PA 19123-1531
Phone: (215) 685-3808
Fax: (215) 685-3848
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 231392 New York
Allopathic & Osteopathic Physicians / Adult Medicine 207QA0505X OS014477 Pennsylvania

Profile Details

NPI number 1336282953
LBN Legal business name Shah, Lisa Jitendra
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 14th, 2007
Last updated Jan 30th, 2012 - about 12 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 1336282953 NPPES
New York Other 231392 LICENSE
New York MEDICAID 02706081 LICENSE

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