MEDICARE: SADASHIV S.SHENOY M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0204X	Vascular & Interventional Radiology Physician	121816-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225081714
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SADASHIV S.SHENOY M.D.

Provider Business Mailing Address
First Line	:	4488 E OVERLOOK DR
Second Line	:
City	:	WILLIAMSVILLE
State	:	NY
Zip	:	14221-6310
Country	:	US
Telephone Number	:	716-631-6736
Fax Number	:

Provider Business Practice Location Address
First Line	:	2949 ELMWOOD AVE
Second Line	:
City	:	KENMORE
State	:	NY
Zip	:	14217-1356
Country	:	US
Telephone Number	:	716-876-4033
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. SADASHIV S. SHENOY
Credential	:	M.D.
Telephone Number	:	716-631-8736

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	07/24/2008

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