Basic Information
Provider Information
NPI: 1912157546
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BATRA
FirstName: SHEENU
MiddleName:  
NamePrefix: MRS.
NameSuffix:  
Credential: P.A.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 19 SCHENCK AVE
Address2: APT 2D
City: GREAT NECK
State: NY
PostalCode: 110213632
CountryCode: US
TelephoneNumber: 5167081266
FaxNumber: 2127301846
Practice Location
Address1: 520 E 70TH ST # 341
Address2:  
City: NEW YORK
State: NY
PostalCode: 100219800
CountryCode: US
TelephoneNumber: 2127467576
FaxNumber: 2127466640
Other Information
ProviderEnumerationDate: 09/18/2008
LastUpdateDate: 09/18/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363AM0700X012369NYY Physician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical

No ID Information.


Home