Provider Demographics
NPI:1700872082
Name:SHIRWAIKAR, ANIL B (MD)
Entity Type:Individual
Prefix:DR
First Name:ANIL
Middle Name:B
Last Name:SHIRWAIKAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 701172
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11370-3172
Mailing Address - Country:US
Mailing Address - Phone:718-507-7404
Mailing Address - Fax:718-507-1060
Practice Address - Street 1:9011 35TH AVE
Practice Address - Street 2:P#2
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-5804
Practice Address - Country:US
Practice Address - Phone:718-507-7404
Practice Address - Fax:718-507-1060
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-22
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY137253207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00735373Medicaid
NY00735373Medicaid
NYB87613Medicare UPIN