Individual
DR. SANJAY SHETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 HEALTHY WAY, OCEANSIDE, NY 11572-1551
(516) 632-3900
Mailing address
70 HARBOR LN, MASSAPEQUA PARK, NY 11762-3902
(917) 589-5109
(516) 799-3864
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
223773
NY
207P00000X
Emergency Medicine Physician
ME89594
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
269588000
—
FL
01
—
43213
BLUE SHIELD OF FL
FL
Enumeration date
06/26/2006
Last updated
08/30/2010
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