Provider Demographics
NPI:1982625752
Name:SHETH, HASMUKH (MD)
Entity Type:Individual
Prefix:DR
First Name:HASMUKH
Middle Name:
Last Name:SHETH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:972 BRUSH HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-1740
Mailing Address - Country:US
Mailing Address - Phone:516-876-5555
Mailing Address - Fax:516-876-1246
Practice Address - Street 1:27005 76TH AVE
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-1433
Practice Address - Country:US
Practice Address - Phone:718-470-7501
Practice Address - Fax:718-470-9113
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2008-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM1346207PE0004X
NY225083207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02324601Medicaid
TX175216402Medicaid
TX175216401Medicaid
TX8U7617OtherBCBS
TX8F1194Medicare PIN
NYH74188Medicare UPIN
TX175216401Medicaid
TX8K3378Medicare PIN
TXH74188Medicare UPIN
TX8D6548Medicare PIN