Provider Demographics
NPI:1063559995
Name:UPADHYAY, SHEILA (MD)
Entity type:Individual
Prefix:MRS
First Name:SHEILA
Middle Name:
Last Name:UPADHYAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:SHEILA
Other - Middle Name:
Other - Last Name:KRISHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3401 CIVIC CENTER BLVD, DEPT OF CHILD PSYCHIATRY
Mailing Address - Street 2:CHILDREN'S HOSPITAL OF PHILADELPHIA
Mailing Address - City:PHILADELPHIA
Mailing Address - State:NY
Mailing Address - Zip Code:19104
Mailing Address - Country:US
Mailing Address - Phone:215-590-7131
Mailing Address - Fax:215-590-4251
Practice Address - Street 1:3401 CIVIC CENTER BLVD DEPT OF
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4319
Practice Address - Country:US
Practice Address - Phone:215-590-7131
Practice Address - Fax:215-590-4251
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY255635208000000X
PAMD4614592084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00590390Medicaid
NY255635OtherLICENSE #
NY00590390Medicaid