Provider Demographics
NPI:1083841886
Name:SHAH, SONYA BABAR (MD)
Entity type:Individual
Prefix:DR
First Name:SONYA
Middle Name:BABAR
Last Name:SHAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1704 S EDGEWOOD ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204-5234
Mailing Address - Country:US
Mailing Address - Phone:845-304-7629
Mailing Address - Fax:
Practice Address - Street 1:6231 LEESBURG PIKE
Practice Address - Street 2:SUITE 608
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22044-2102
Practice Address - Country:US
Practice Address - Phone:703-534-3900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-18
Last Update Date:2017-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101256261207W00000X, 207WX0009X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0009XAllopathic & Osteopathic PhysiciansOphthalmologyGlaucoma Specialist