Provider Demographics
NPI:1861544157
Name:CALONSHAH MD LLC
Entity type:Organization
Organization Name:CALONSHAH MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARITONI
Authorized Official - Middle Name:
Authorized Official - Last Name:CALON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-448-7300
Mailing Address - Street 1:8 ALFALFA CIR
Mailing Address - Street 2:
Mailing Address - City:PLAINSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08536-3141
Mailing Address - Country:US
Mailing Address - Phone:609-448-7300
Mailing Address - Fax:609-448-8022
Practice Address - Street 1:300B PRINCTON HIGHTSTOWN RD
Practice Address - Street 2:SUITE # 201
Practice Address - City:HIGHTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08520
Practice Address - Country:US
Practice Address - Phone:609-448-7300
Practice Address - Fax:609-448-8022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA072698207RA0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RA0000XAllopathic & Osteopathic PhysiciansInternal MedicineAdolescent MedicineGroup - Single Specialty