Provider Demographics
NPI:1588820856
Name:DESOUZA, SHILPA ANNE (MD)
Entity type:Individual
Prefix:DR
First Name:SHILPA
Middle Name:ANNE
Last Name:DESOUZA
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 1:222 STATION PLZ N
Mailing Address - Street 2:SUITE 400
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-3800
Mailing Address - Country:US
Mailing Address - Phone:516-663-2834
Mailing Address - Fax:516-663-4696
Practice Address - Street 1:222 STATION PLZ N
Practice Address - Street 2:SUITE 400
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-3800
Practice Address - Country:US
Practice Address - Phone:516-663-2834
Practice Address - Fax:516-663-4696
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-05
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY260835207R00000X, 207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine