National Provider Identifier
Syed Jibran Shah, D.O
Syed Jibran Shah, D.O is listed in the NPPES registry with a primary specialty of Family Medicine Physician in Ithaca, NY and a listed phone number of (607) 257-5858.
Profile Overview
- NPI
- 1518385269
- Provider Type
- Individual
- Primary Specialty
- Family Medicine Physician
- Enumeration Date
- March 31, 2014
- Last Updated
- July 21, 2022
Practice Location
- 1780 Hanshaw RD
- Ithaca, NY 14850-9105
Phone: (607) 257-5858
Mailing Address
- One Guthrie Square
- Sayre, PA 18840-1625
Specialties
- Family Medicine Physician (207Q00000X)
- Student in an Organized Health Care Education/Training Program (390200000X)
Full Record
- NPI
- 1518385269
- Entity Type
- Individual
- Last Name
- Shah
- First Name
- Syed
- Middle Name
- Jibran
- Credential
- D.O
- Mailing Street Address
- One Guthrie Square
- Mailing City
- Sayre
- Mailing State
- PA
- Mailing ZIP Code
- 18840-1625
- Mailing Country
- US
- Mailing Phone
- (570) 888-5858
- Practice Street Address
- 1780 Hanshaw RD
- Practice City
- Ithaca
- Practice State
- NY
- Practice ZIP Code
- 14850-9105
- Practice Country
- US
- Practice Phone
- (607) 257-5858
- Practice Fax
- (607) 257-1718
- Enumeration Date
- March 31, 2014
- Last Updated
- July 21, 2022
- Sex
- Male
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Family Medicine Physician (207Q00000X), Student in an Organized Health Care Education/Training Program (390200000X)