Provider Demographics
NPI:1558407247
Name:SETTY, SHAILAJA N (MD)
Entity Type:Individual
Prefix:DR
First Name:SHAILAJA
Middle Name:N
Last Name:SETTY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SHAILAJA
Other - Middle Name:S
Other - Last Name:NARAYANA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:33 FERNCLIFF RD
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-5955
Mailing Address - Country:US
Mailing Address - Phone:914-722-2019
Mailing Address - Fax:914-472-8585
Practice Address - Street 1:22 5TH ST
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-5030
Practice Address - Country:US
Practice Address - Phone:203-323-8160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT41272208000000X
NY237989208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02473081Medicaid
CT008082421Medicaid
NY548Z21Medicare ID - Type Unspecified