Basic Information
| Provider Information | |||||||||
| NPI: | 1417388711 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | SHAH | ||||||||
| FirstName: | NAURA | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 526 MAIN ST STE 302 | ||||||||
| Address2: | |||||||||
| City: | ACTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 017203301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9783717010 | ||||||||
| FaxNumber: | 9783710522 | ||||||||
| Practice Location | |||||||||
| Address1: | 128 CARNEGIE ROW | ||||||||
| Address2: | |||||||||
| City: | NORWOOD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 020625161 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7817625858 | ||||||||
| FaxNumber: | 7817623307 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/11/2013 | ||||||||
| LastUpdateDate: | 08/05/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/05/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 50.004555RX | OH | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363A00000X | C5-0001101 | DE | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363A00000X | 0110004310 | VA | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 207N00000X | PA7118 | MA | Y | Allopathic & Osteopathic Physicians | Dermatology |
No ID Information.