| Shyam Shivdasani Md Pllc | |
|
800 Community Dr Suite 207 Manhasset NY 11030-3822 | |
| (516) 426-7750 | |
| (516) 627-0464 |
| Full Name | Shyam Shivdasani Md Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 800 Community Dr, Manhasset, New York |
| Authorized Official Name and Position | Shaleen Shivdasani (VP) |
| Authorized Official Contact | 5162421430 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shyam Shivdasani Md Pllc 21 Reni Rd Manhasset NY 11030-1222 Ph: (516) 869-3210 | Shyam Shivdasani Md Pllc 800 Community Dr Suite 207 Manhasset NY 11030-3822 Ph: (516) 426-7750 |
| NPI Number | 1306225669 |
|---|---|
| Provider Enumeration Date | 05/20/2015 |
| Last Update Date | 05/20/2015 |
| Medicare PECOS PAC ID | 7911210547 |
|---|---|
| Medicare Enrollment ID | O20150724011329 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306225669 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 196192 (New York) | Primary |
| Provider Name | Shyam C Shivdasani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033222468 PECOS PAC ID: 3779575535 Enrollment ID: I20040401000149 |
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