Provider Demographics
NPI:1457672271
Name:SHOSHANI, NECHAMA (MD)
Entity Type:Individual
Prefix:DR
First Name:NECHAMA
Middle Name:
Last Name:SHOSHANI
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 1:119 N PARK AVE
Mailing Address - Street 2:SUITE 208
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-4113
Mailing Address - Country:US
Mailing Address - Phone:631-265-8780
Mailing Address - Fax:
Practice Address - Street 1:119 N PARK AVE
Practice Address - Street 2:SUITE 208
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-4113
Practice Address - Country:US
Practice Address - Phone:631-265-8780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-16
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY263304207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology