Healthcare Provider Details

I. General information

NPI: 1295392439
Provider Name (Legal Business Name): VIKAS SHAHI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2019
Last Update Date: 05/11/2025
Certification Date: 05/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 E 70TH ST
NEW YORK NY
10021-4898
US

IV. Provider business mailing address

535 E 70TH ST
NEW YORK NY
10021-4898
US

V. Phone/Fax

Practice location:
  • Phone: 212-224-7996
  • Fax: 917-260-4995
Mailing address:
  • Phone: 212-224-7996
  • Fax: 917-260-4995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number330013
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207PS0010X
TaxonomySports Medicine (Emergency Medicine) Physician
License Number330013
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: