Provider Demographics
NPI:1831721430
Name:SHI, WILLIAM Y (MD PHD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:Y
Last Name:SHI
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DEPARTMENT OF CARDIOVASCULAR SURGERY
Mailing Address - Street 2:NORTH SHORE UNIVERSITY HOSPITAL, 300 COMMUNITY DRIVE
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030
Mailing Address - Country:US
Mailing Address - Phone:516-562-4970
Mailing Address - Fax:
Practice Address - Street 1:NORTH SHORE UNIVERSITY HOSPITAL
Practice Address - Street 2:CARDIOVASCULAR SURGERY, 300 COMMUNITY DRIVE
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030
Practice Address - Country:US
Practice Address - Phone:617-543-6696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-11
Last Update Date:2023-01-18
Deactivation Date:2020-12-08
Deactivation Code:
Reactivation Date:2021-01-13
Provider Licenses
StateLicense IDTaxonomies
NY315805208G00000X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY315805OtherMEDICAL LICENSE