Provider Demographics
NPI:1245502822
Name:KARDAM, SHALINI PRIYA (MD)
Entity type:Individual
Prefix:DR
First Name:SHALINI
Middle Name:PRIYA
Last Name:KARDAM
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 1:753 CLASSON AVE APT LF
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-4614
Mailing Address - Country:US
Mailing Address - Phone:718-288-7952
Mailing Address - Fax:
Practice Address - Street 1:753 CLASSON AVE APT LF
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-4614
Practice Address - Country:US
Practice Address - Phone:718-288-7952
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-30
Last Update Date:2015-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN50830207R00000X
PAMD446874207R00000X
NJ25MA09187100207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine