Provider Demographics
NPI:1679687024
Name:SHIRKE, ANEIL M (MD)
Entity Type:Individual
Prefix:
First Name:ANEIL
Middle Name:M
Last Name:SHIRKE
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 1:26 W 9TH ST APT 8E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-8924
Mailing Address - Country:US
Mailing Address - Phone:212-505-5983
Mailing Address - Fax:212-929-7575
Practice Address - Street 1:26 W 9TH ST APT 8E
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8924
Practice Address - Country:US
Practice Address - Phone:212-505-5983
Practice Address - Fax:212-929-7575
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY214-6722084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY386-BX1Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID