Provider Demographics
NPI:1811234388
Name:HARI PRASAD SHETTY ANESTHESIOLOGY PC
Entity Type:Organization
Organization Name:HARI PRASAD SHETTY ANESTHESIOLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HARI
Authorized Official - Middle Name:PRASAD
Authorized Official - Last Name:SHETTY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-583-5415
Mailing Address - Street 1:44 AMBASSADOR LN
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10309-1996
Mailing Address - Country:US
Mailing Address - Phone:917-583-5415
Mailing Address - Fax:
Practice Address - Street 1:44 AMBASSADOR LN
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10309-1996
Practice Address - Country:US
Practice Address - Phone:917-583-5415
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-03
Last Update Date:2013-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY237734207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty