Individual
SHIVANAND SHANKAR MEDAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
111 E 210TH ST, MONTEFIORE MEDICAL CENTER, BRONX, NY 10467-2401
(718) 741-2440
Mailing address
3450 WAYNE AVE, APT#12H, BRONX, NY 10467-2510
(347) 431-7779
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
266896
NY
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
266896
NY
Other
Enumeration date
05/18/2008
Last updated
11/10/2025
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