Provider Demographics
NPI:1013900463
Name:SHELDON MEDICAL CARE,PC
Entity Type:Organization
Organization Name:SHELDON MEDICAL CARE,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TUSHAR
Authorized Official - Middle Name:L
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-220-7677
Mailing Address - Street 1:115 BRAMBLEBROOK RD
Mailing Address - Street 2:
Mailing Address - City:ARDSLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10502-2206
Mailing Address - Country:US
Mailing Address - Phone:718-220-7677
Mailing Address - Fax:718-220-7679
Practice Address - Street 1:2435 JEROME AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10468-6402
Practice Address - Country:US
Practice Address - Phone:718-220-7677
Practice Address - Fax:718-220-7679
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-31
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWEX551Medicare PIN