MEDICARE: DR.SHAKUNTALA J MARKALE

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	122300000X	Dentist	37311	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	:	1831361674
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR.SHAKUNTALA J MARKALE

Provider Business Mailing Address
First Line	:	1171 GRAND CONCOURSE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10452-8543
Country	:	US
Telephone Number	:	718-588-7878
Fax Number	:	718-588-2232

Provider Business Practice Location Address
First Line	:	1171 GRAND CONCOURSE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10452-8543
Country	:	US
Telephone Number	:	718-588-7878
Fax Number	:	718-588-2232

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. JAGDISH N MARKALE
Credential	:	DDS
Telephone Number	:	71858878781

Provider Enumeration Date	:	04/01/2008
Last Update Date	:	04/01/2008

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