Provider Demographics
NPI:1730715194
Name:SHAH, NILESH B
Entity type:Individual
Prefix:
First Name:NILESH
Middle Name:B
Last Name:SHAH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 FRANKLIN ST APT 322
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01608-1914
Mailing Address - Country:US
Mailing Address - Phone:347-205-3612
Mailing Address - Fax:
Practice Address - Street 1:50 FRANKLIN ST APT 322
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-1914
Practice Address - Country:US
Practice Address - Phone:347-205-3612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-18
Last Update Date:2020-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist