Provider Demographics
NPI:1871545665
Name:SHENOY, NARAYANA AS (MD)
Entity type:Individual
Prefix:
First Name:NARAYANA
Middle Name:AS
Last Name:SHENOY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 WEISS AVE
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-4632
Mailing Address - Country:US
Mailing Address - Phone:716-674-6612
Mailing Address - Fax:716-674-7299
Practice Address - Street 1:66 WEISS AVE
Practice Address - Street 2:
Practice Address - City:W SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224
Practice Address - Country:US
Practice Address - Phone:716-674-6612
Practice Address - Fax:716-674-7299
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY145153207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY005008873OtherBLUE CROSS BLUE SHIELD
NY0404190OtherINDEPENDANT HEALTH
NY00943471Medicaid
NY005008873OtherBLUE CROSS BLUE SHIELD
D74806Medicare UPIN