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Organization
SHYAM C. SHIVDASANI, MD INTERNAL MEDICINE PLLC
Active
Organization
SHYAM C. SHIVDASANI, MD INTERNAL MEDICINE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHALEEN MAKHIJANI SHIVDASANI CPA (VP)
(516) 242-1430
Entity
Organization
Contact information
Practice address
140 LOCKWOOD AVE, SUITE #216, NEW ROCHELLE, NY 10801-4915
(914) 235-6900
(914) 235-7900
Mailing address
21 RENI RD, MANHASSET, NY 11030-1222
(516) 869-3210
(516) 627-0464
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
196192
NY
207R00000X
Internal Medicine Physician
Primary
196192
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002918
CONNECICARE #
NY
05
—
01851505
—
NY
01
—
0203874
GHI NON-PAR #
NY
01
—
163AJ3
EMPIRE BC/BS #
NY
01
—
1896297
CIGNA #
NY
01
—
196192
HIP #
NY
01
—
2592106
GHI #
NY
01
—
3359089
AETNA HMO #
NY
01
—
3C2846
HEALTHNET (PHS) #
NY
01
—
5387184
AETNA PPO #
NY
01
—
DE7187
MEDICARE RAILROAD
NY
01
—
SS6192
ATLANTIS HEALTHPLAN #
NY
01
—
WP738
OXFORD #
NY
Enumeration date
10/19/2006
Last updated
05/29/2008
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