MEDICARE: DR. SHASHI LALL 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	207QA0505X	Adult Medicine Physician	146834	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	:	1730166448
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHASHI LALL M.D.

Provider Business Mailing Address
First Line	:	725 ORCHARD PARK RD
Second Line	:	SUITE A
City	:	WEST SENECA
State	:	NY
Zip	:	14224-3352
Country	:	US
Telephone Number	:	716-675-1001
Fax Number	:	716-675-3832

Provider Business Practice Location Address
First Line	:	725 ORCHARD PARK RD
Second Line	:	SUITE A
City	:	WEST SENECA
State	:	NY
Zip	:	14224-3352
Country	:	US
Telephone Number	:	716-675-1001
Fax Number	:	716-675-3832

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/23/2005
Last Update Date	:	07/08/2007

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Directions to “ DR. SHASHI LALL M.D.” Practice Location

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