Provider Demographics
NPI:1225765753
Name:SHEETAL DEO MEDICAL PC
Entity Type:Organization
Organization Name:SHEETAL DEO MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SHEETAL
Authorized Official - Middle Name:
Authorized Official - Last Name:DEO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:516-728-2788
Mailing Address - Street 1:23 JEAN PL
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-5917
Mailing Address - Country:US
Mailing Address - Phone:516-728-2788
Mailing Address - Fax:
Practice Address - Street 1:44 E 32ND ST FL 8
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-5557
Practice Address - Country:US
Practice Address - Phone:212-596-4360
Practice Address - Fax:212-966-2378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-04
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1679778922OtherNPI
NY255073OtherNEW YORK STATE LICENSE
NYFD2010483OtherDEA