Basic Information
| Provider Information | |||||||||
| NPI: | 1457688285 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHENOY | ||||||||
| FirstName: | SHANTHERI | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 409 RIVER PARK DR | ||||||||
| Address2: | |||||||||
| City: | RARITAN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 088692146 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3479332771 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1111 AMSTERDAM AVE | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100251716 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2125232900 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/16/2009 | ||||||||
| LastUpdateDate: | 09/06/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 09/06/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | 272562 | NY | Y | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.