Provider Demographics
NPI:1316181936
Name:SADASHIV S SHENOY MD PLLC
Entity Type:Organization
Organization Name:SADASHIV S SHENOY MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SADASHIV
Authorized Official - Middle Name:S
Authorized Official - Last Name:SHENOY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-877-0053
Mailing Address - Street 1:PO BOX 8000
Mailing Address - Street 2:DEPT 867
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14267-0002
Mailing Address - Country:US
Mailing Address - Phone:716-877-0053
Mailing Address - Fax:716-877-1767
Practice Address - Street 1:2950 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:KENMORE
Practice Address - State:NY
Practice Address - Zip Code:14217
Practice Address - Country:US
Practice Address - Phone:716-877-0053
Practice Address - Fax:716-877-1767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-27
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1218162085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Multi-Specialty