Provider Demographics
NPI:1598093106
Name:NITIN D SHETH SURGEON PC
Entity Type:Organization
Organization Name:NITIN D SHETH SURGEON PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:NITIN
Authorized Official - Middle Name:D
Authorized Official - Last Name:SHETH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-780-0566
Mailing Address - Street 1:303 2ND AVE
Mailing Address - Street 2:SUITE 20
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-2739
Mailing Address - Country:US
Mailing Address - Phone:212-780-0566
Mailing Address - Fax:
Practice Address - Street 1:303 2ND AVE
Practice Address - Street 2:SUITE 20
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-2739
Practice Address - Country:US
Practice Address - Phone:212-780-0566
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-20
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY155216208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY23D811Medicare PIN