Provider Demographics
NPI:1396033437
Name:SHAH, RUCHIR ASHWINBHAI (MD)
Entity type:Individual
Prefix:
First Name:RUCHIR
Middle Name:ASHWINBHAI
Last Name:SHAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:465 SOUTH ST STE 103
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-6442
Mailing Address - Country:US
Mailing Address - Phone:973-971-5198
Mailing Address - Fax:973-605-8854
Practice Address - Street 1:100 MADISON AVE
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-6136
Practice Address - Country:US
Practice Address - Phone:973-971-5198
Practice Address - Fax:973-605-8854
Is Sole Proprietor?:No
Enumeration Date:2011-07-11
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2015-008642084N0400X, 2084V0102X
FLME1430612084N0400X
LA3379932084N0400X
TN538882084N0400X, 2084V0102X
IN01082180A2084N0400X
NJ25MA116999002084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME143061OtherSTATE LICENSE
LA337993OtherLA LICENSE