Basic Information
| Provider Information | |||||||||
| NPI: | 1528565629 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SHAH-SIEGEL | ||||||||
| FirstName: | PINKEY | ||||||||
| MiddleName: | |||||||||
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| Credential: | DO | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | SHAH | ||||||||
| OtherFirstName: | PINKEY | ||||||||
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| OtherCredential: | DO | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 231 ALBERT SABIN WAY PO BOX 0531 | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452672827 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5135586356 | ||||||||
| FaxNumber: | 5125580995 | ||||||||
| Practice Location | |||||||||
| Address1: | 3188 BELLEVUE AVENUE | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 45219 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5135841000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/06/2018 | ||||||||
| LastUpdateDate: | 09/28/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/27/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207L00000X | 58.03032 | OH | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.