Provider Demographics
NPI:1861666877
Name:SHILPEE, FERDOUSI BEGUM (MD)
Entity Type:Individual
Prefix:
First Name:FERDOUSI
Middle Name:BEGUM
Last Name:SHILPEE
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 1:504 MEDFORD AVE
Mailing Address - Street 2:
Mailing Address - City:PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772-1321
Mailing Address - Country:US
Mailing Address - Phone:631-475-4646
Mailing Address - Fax:631-447-5234
Practice Address - Street 1:504 MEDFORD AVE
Practice Address - Street 2:
Practice Address - City:PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-1321
Practice Address - Country:US
Practice Address - Phone:631-475-4646
Practice Address - Fax:631-447-5234
Is Sole Proprietor?:No
Enumeration Date:2008-04-22
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY247597207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03023049Medicaid
NYA400005625Medicare PIN