Individual ProviderDivya ShahInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address17 E 102nd St, New York, NY 10029-5204(212) 659-8551PECOS EnrollmentBased on the most recent information from CMS, provider Divya Shah is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 6 days ago.Profile DetailsProvider ID1558980045Provider TypeIndividualFull NameShah, DivyaTitleDr.CredentialMDGenderFemaleSole ProprietorNoEnumeration Date4/14/2020Last Updated8/9/2023Contact InformationPractice LocationPractice Address17 E 102nd St, New York, NY 10029-5204Phone(212) 659-8551Fax(212) 831-8116Mailing LocationMailing Address1 Gustave L Levy Pl # 1118, New York, NY 10029-6504PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense323306New York