MEDICARE: DR. ALEKSANDER SHALSHIN MD

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	207R00000X	Internal Medicine Physician	244964	NY
2	207RC0000X	Cardiovascular Disease Physician	244964	NY
3	207RH0002X	Hospice and Palliative Medicine (Internal Medicine) Physician	244964	NY
4	207RP1001X	Pulmonary Disease Physician	244964	NY

General Provider Information

NPI Number	:	1790983450
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALEKSANDER SHALSHIN MD

Provider Business Mailing Address
First Line	:	PO BOX 918
Second Line	:
City	:	SYOSSET
State	:	NY
Zip	:	11791-0079
Country	:	US
Telephone Number	:	631-271-9151
Fax Number	:	631-271-9155

Provider Business Practice Location Address
First Line	:	60 QUEENS ST STE 100
Second Line	:
City	:	SYOSSET
State	:	NY
Zip	:	11791-3058
Country	:	US
Telephone Number	:	631-271-9151
Fax Number	:	631-271-9155

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

Provider Enumeration Date	:	07/04/2007
Last Update Date	:	01/08/2025

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