Individual
FNU SHAILESH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4417 VESTAL PKWY E, VESTAL, NY 13850-3556
(607) 729-8833
Mailing address
33 LEWIS RD, 2ND FLOOR, BINGHAMTON, NY 13905-1048
(607) 729-8156
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
283098
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04503760
—
NY
Enumeration date
09/15/2010
Last updated
04/25/2017
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