Provider Demographics
NPI:1659333680
Name:SHETH, SNEHAL R (MD)
Entity Type:Individual
Prefix:
First Name:SNEHAL
Middle Name:R
Last Name:SHETH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 NORTH RD
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-1154
Mailing Address - Country:US
Mailing Address - Phone:845-431-8853
Mailing Address - Fax:845-485-3809
Practice Address - Street 1:241 NORTH RD
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-1154
Practice Address - Country:US
Practice Address - Phone:845-431-8853
Practice Address - Fax:845-485-3809
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-05
Last Update Date:2016-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY185706-12084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01715379Medicaid
NY01715379Medicaid
NYG25255Medicare UPIN