{
"Npi": {
"NPI": "1396124608",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "WANCHOO",
"FirstName": "SHESHALI",
"MiddleName": "JAIKRISHAN",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "D.O.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "800 WASHINGTON ST # 369",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BOSTON",
"MailingAddressStateName": "MA",
"MailingAddressPostalCode": "02111-1552",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "617-636-6366",
"MailingAddressFaxNumber": "617-636-6361",
"FirstLinePracticeLocationAddress": "8900 VAN WYCK EXPY",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "RICHMOND HILL",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "11418-2897",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "718-206-6057",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/20/2015",
"LastUpdateDate": "09/02/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "207R00000X",
"TaxonomyName": "Internal Medicine Physician",
"LicenseNumber": "S7155",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "207R00000X",
"TaxonomyName": "Internal Medicine Physician",
"LicenseNumber": "288699",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "207RC0200X",
"TaxonomyName": "Critical Care Medicine (Internal Medicine) Physician",
"LicenseNumber": "1015346",
"LicenseNumberStateCode": "MA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "2084A2900X",
"TaxonomyName": "Neurocritical Care Physician",
"LicenseNumber": "S7155",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "207RC0200X",
"TaxonomyName": "Critical Care Medicine (Internal Medicine) Physician",
"LicenseNumber": "288699",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}