Provider Demographics
NPI:1376118455
Name:SHYAM, SHARVARI (MD)
Entity Type:Individual
Prefix:
First Name:SHARVARI
Middle Name:
Last Name:SHYAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:THIRD AVENUE BRONX
Mailing Address - Street 2:SBH HEALTH SYSTEM 4422
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10457
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:THIRD AVENUE BRONX
Practice Address - Street 2:SBH HEALTH SYSTEM 4422
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10457
Practice Address - Country:US
Practice Address - Phone:718-960-9000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-21
Last Update Date:2022-11-21
Deactivation Date:2022-11-14
Deactivation Code:
Reactivation Date:2022-11-21
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program