Provider Demographics
NPI:1558983072
Name:SHRIMANKER, ISHA MAYUR (MD)
Entity Type:Individual
Prefix:MS
First Name:ISHA
Middle Name:MAYUR
Last Name:SHRIMANKER
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 1:101 DATES DRIVE
Mailing Address - Street 2:INTERNAL MEDICINE RESIDENCY
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850
Mailing Address - Country:US
Mailing Address - Phone:607-252-3455
Mailing Address - Fax:
Practice Address - Street 1:101 DATES DRIVE
Practice Address - Street 2:INTERNAL MEDICINE RESIDENCY
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850
Practice Address - Country:US
Practice Address - Phone:607-252-3455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-07
Last Update Date:2022-06-01
Deactivation Date:2022-01-11
Deactivation Code:
Reactivation Date:2022-06-01
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program