Provider Demographics
NPI:1750602181
Name:HIROMI SHINYA MD, PC
Entity type:Organization
Organization Name:HIROMI SHINYA MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:HIROMI
Authorized Official - Middle Name:
Authorized Official - Last Name:SHINYA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-751-9714
Mailing Address - Street 1:305 EAST 55TH STREET
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022
Mailing Address - Country:US
Mailing Address - Phone:212-751-9714
Mailing Address - Fax:212-832-1821
Practice Address - Street 1:305 EAST 55TH STREET
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022
Practice Address - Country:US
Practice Address - Phone:212-751-9714
Practice Address - Fax:212-832-1821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-21
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC11387Medicare UPIN
NY561131Medicare PIN