Healthcare Provider Details

I. General information

NPI: 1396709838
Provider Name (Legal Business Name): SHIREEN A PAIS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2006
Last Update Date: 12/17/2021
Certification Date: 12/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2050 SAW MILL RIVER RD
YORKTOWN HEIGHTS NY
10598-4143
US

IV. Provider business mailing address

2649 STRANG BLVD STE 304
YORKTOWN HEIGHTS NY
10598-2938
US

V. Phone/Fax

Practice location:
  • Phone: 914-233-3008
  • Fax: 914-233-3011
Mailing address:
  • Phone: 914-739-0087
  • Fax: 914-737-1714

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number240734
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number01060360
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: