Provider Demographics
NPI:1487733705
Name:SHAH, SANDHYA T (MD)
Entity type:Individual
Prefix:
First Name:SANDHYA
Middle Name:T
Last Name:SHAH
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1180 BEACON ST
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-3885
Mailing Address - Country:US
Mailing Address - Phone:617-232-1220
Mailing Address - Fax:617-738-8952
Practice Address - Street 1:1180 BEACON ST
Practice Address - Street 2:SUITE 2A
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-3885
Practice Address - Country:US
Practice Address - Phone:617-232-1220
Practice Address - Fax:617-738-8952
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2009-08-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA46454174400000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0159972Medicaid
MANP0022070OtherNEIGHBORHOOD HP
MA046454OtherTUFTS HP
MA99244302OtherNETWORK HEALTH
MAE05777OtherBCBS
MAB73832BIOtherHARVARD PILGRIM HC
MA0159972Medicaid