MEDICARE: DR. SHALINI BOBRA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	239785	NY

General Provider Information

NPI Number	:	1376738237
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHALINI BOBRA M.D.

Provider Business Mailing Address
First Line	:	16 FAWN LN
Second Line	:
City	:	ARMONK
State	:	NY
Zip	:	10504-1126
Country	:	US
Telephone Number	:	718-684-5131
Fax Number	:	718-684-5133

Provider Business Practice Location Address
First Line	:	3130 GRAND CONCOURSE
Second Line	:	SUITE 1V
City	:	BRONX
State	:	NY
Zip	:	10458-1213
Country	:	US
Telephone Number	:	718-684-5131
Fax Number	:	718-684-5133

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/12/2007
Last Update Date	:	01/07/2013

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