Healthcare Provider Details

I. General information

NPI: 1821153750
Provider Name (Legal Business Name): HANSRAJ SHETH GENERAL SURGERY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2006
Last Update Date: 03/09/2023
Certification Date: 03/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

667 STONELEIGH AVE STE 302
CARMEL NY
10512-2455
US

IV. Provider business mailing address

PO BOX 1140
CARMEL NY
10512-8140
US

V. Phone/Fax

Practice location:
  • Phone: 845-582-0919
  • Fax: 845-582-0922
Mailing address:
  • Phone: 845-582-0919
  • Fax: 845-582-0922

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number228725-1
License Number StateNY

VIII. Authorized Official

Name: DR. HANSRAJ SHETH
Title or Position: OWNER
Credential: MD
Phone: 845-228-4444