Provider Demographics
NPI:1205123973
Name:DAVID, SHANY (MD)
Entity type:Individual
Prefix:
First Name:SHANY
Middle Name:
Last Name:DAVID
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:151 E 62ND ST
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-7620
Mailing Address - Country:US
Mailing Address - Phone:212-288-8832
Mailing Address - Fax:646-924-0579
Practice Address - Street 1:151 E 62ND ST
Practice Address - Street 2:SUITE 1A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-7620
Practice Address - Country:US
Practice Address - Phone:212-288-8832
Practice Address - Fax:646-924-0579
Is Sole Proprietor?:No
Enumeration Date:2011-07-01
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY267562-12084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology