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General NPI Number Information
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NPI Number | 1396124608
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Entity Type | Individual
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Provider Name | SHESHALI JAIKRISHAN WANCHOO D.O.
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Gender | Female
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Dates
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Enumeration Date | 05/20/2015
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 8900 VAN WYCK EXPY
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City | RICHMOND HILL
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State | NY
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Zip | 11418-2897
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Country | US
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Telephone | 718-206-6057
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Fax |
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Provider Business Mailing Address
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Address Line | 800 WASHINGTON ST # 369
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City | BOSTON
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State | MA
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Zip | 02111-1552
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Country | US
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Telephone | 617-636-6366
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Fax | 617-636-6361
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | S7155
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 288699
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 1015346
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License Number State | MA
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Taxonomy #4
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Taxonomy Code | 2084A2900X
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Taxonomy Name | Neurocritical Care Physician
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License Number | S7155
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 288699
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License Number State | NY
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