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General NPI Number Information
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NPI Number | 1073940656
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Entity Type | Organization
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Legal Business Name | PRADIP R. SHETYE, DDS, PC
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Dates
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Enumeration Date | 09/27/2013
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Last Update Date | 10/02/2013
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Provider Practice Location Address
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Address Line | 307 EAST 33TH STREET LOWER LEVEL
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City | NEW YORK
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State | NY
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Zip | 10016
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Country | US
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Telephone | 212-263-5204
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Fax | 212-263-0882
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Provider Business Mailing Address
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Address Line | 333 EAST 30TH STREET APT 1H
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City | NEW YORK
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State | NY
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Zip | 10016
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | PRADIP SHETYE
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Credential | DDS, MDS
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Telephone | 917-553-0349
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 055911
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License Number State | NY
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