National Provider Identifier
Imtiaz Ali Shah, MD
Imtiaz Ali Shah, MD is listed in the NPPES registry with a primary specialty of Student in an Organized Health Care Education/Training Program in Elmira, NY and a listed phone number of (607) 442-1716.
Profile Overview
- NPI
- 1992558027
- Provider Type
- Individual
- Primary Specialty
- Student in an Organized Health Care Education/Training Program
- Enumeration Date
- April 09, 2024
- Last Updated
- April 09, 2024
Practice Location
- 600 Roe Ave
- Elmira, NY 14905-1676
Phone: (607) 442-1716
Mailing Address
- 35 Lyndale Ave
- Buffalo, NY 14223-3021
Specialties
- Student in an Organized Health Care Education/Training Program (390200000X)
Full Record
- NPI
- 1992558027
- Entity Type
- Individual
- Last Name
- Shah
- First Name
- Imtiaz
- Middle Name
- Ali
- Name Prefix
- Dr.
- Credential
- MD
- Mailing Street Address
- 35 Lyndale Ave
- Mailing City
- Buffalo
- Mailing State
- NY
- Mailing ZIP Code
- 14223-3021
- Mailing Country
- US
- Mailing Phone
- (716) 808-1692
- Practice Street Address
- 600 Roe Ave
- Practice City
- Elmira
- Practice State
- NY
- Practice ZIP Code
- 14905-1676
- Practice Country
- US
- Practice Phone
- (607) 442-1716
- Practice Fax
- (607) 873-7359
- Enumeration Date
- April 09, 2024
- Last Updated
- April 09, 2024
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- April 04, 2024
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Student in an Organized Health Care Education/Training Program (390200000X)