1477547446 NPI number — ANITA CHATLANI SHAH MD

Table of content: ANITA CHATLANI SHAH MD (NPI 1477547446)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477547446 NPI number — ANITA CHATLANI SHAH MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SHAH
Provider First Name:
ANITA
Provider Middle Name:
CHATLANI
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1477547446
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/03/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20 GRAND STREET
Provider Second Line Business Mailing Address:
3RD FLOOR
Provider Business Mailing Address City Name:
WARWICK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10990-1035
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
845-353-5600
Provider Business Mailing Address Fax Number:
845-987-5979

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2 CROSFIELD AVE
Provider Second Line Business Practice Location Address:
STE 318
Provider Business Practice Location Address City Name:
WEST NYACK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10994-2226
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-353-5600
Provider Business Practice Location Address Fax Number:
845-353-5668
Provider Enumeration Date:
09/07/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  2156351 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 132995699 . This is a "HUDSON HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 132995699 . This is a "MAGNACARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 215635 . This is a "LICENSE NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 015AE1 . This is a "BC BS EMPIRE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 02200755 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0D2175 . This is a "HEALTHNET OF THE NORTH EA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 132995699 . This is a "HEALTH NOW" identifier . This identifiers is of the category "OTHER".
  • Identifier: 132995699 . This is a "HORIZON HEALTHCARE OF NY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2594362 . This is a "GHI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0057864 . This is a "GHI HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 45022P . This is a "HIP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 132995699 . This is a "INDECS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 040426012111 . This is a "FIDELIS MEDICAID HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0890100002 . This is a "CIGNA HMO POS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 132995699 . This is a "BEECH STREET NETWORK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 132995699 . This is a "LOCAL 1199" identifier . This identifiers is of the category "OTHER".
  • Identifier: 132995699 . This is a "CIGNA PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 132995699 . This is a "FAM HEALTH PLUS HUDSON HP" identifier . This identifiers is of the category "OTHER".




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