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General NPI Number Information
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NPI Number | 1992717938
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Entity Type | Individual
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Provider Name | TRACY SHEVELL MD
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Gender | Female
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Dates
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Enumeration Date | 08/11/2006
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Last Update Date | 05/11/2021
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Provider Practice Location Address
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Address Line | 480 BEDFORD RD
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City | CHAPPAQUA
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State | NY
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Zip | 10514-1715
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Country | US
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Telephone | 203-276-7060
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Fax |
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Provider Business Mailing Address
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Address Line | MATERNAL FETAL MEDICINE OBGYN/NORTHWELL HEALTH 480 BEDFORD RD
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City | CHAPPAQUA
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State | NY
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Zip | 10514
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Country | US
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Telephone | 914-458-8800
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Fax |
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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 | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 042137
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 211664
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number | 042137
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License Number State | CT
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Taxonomy #4
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Taxonomy Code | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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License Number | 042137
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License Number State | CT
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Taxonomy #5
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Taxonomy Code | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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License Number | 211664
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License Number State | NY
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Taxonomy #6
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Taxonomy Code | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number | 211664
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License Number State | NY
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