Provider Demographics
NPI:1245296458
Name:SHANI, DANA (MD)
Entity type:Individual
Prefix:DR
First Name:DANA
Middle Name:
Last Name:SHANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:
Other - Last Name:SHANI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:178 EAST 85 STREET
Mailing Address - Street 2:4 FLOOR
Mailing Address - City:NEW YORK CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10028-2119
Mailing Address - Country:US
Mailing Address - Phone:212-434-3630
Mailing Address - Fax:212-434-3639
Practice Address - Street 1:178 EAST 85 STREET
Practice Address - Street 2:4 FLOOR
Practice Address - City:NEW YORK CITY
Practice Address - State:NY
Practice Address - Zip Code:10028-2119
Practice Address - Country:US
Practice Address - Phone:212-434-3630
Practice Address - Fax:212-434-3639
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-25
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY168406207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01056500Medicaid
NY94D811Medicare ID - Type Unspecified
NY01056500Medicaid