Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 301250 | NY |
N | 207RC0000X | Internist - Cardiovascular Disease | A133760 | CA |
NPI | 1821431040 |
---|---|
Provider Name | Shudhanshu Alishetti |
First Address | New York, NY 10021-5504 |
Second Address | Brooklyn, NY 11215-3609 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2013 |
Last Update Date | 14/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
SA3232267556 | OTHER (01) | CA |