Provider Demographics
NPI:1427811504
Name:YADAV, SHANKAR PRASAD (MD)
Entity type:Individual
Prefix:
First Name:SHANKAR
Middle Name:PRASAD
Last Name:YADAV
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 1:269-01 76TH AVENUE
Mailing Address - Street 2:C-LEVEL ROOM C028
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040
Mailing Address - Country:US
Mailing Address - Phone:718-470-3449
Mailing Address - Fax:
Practice Address - Street 1:269-01 76TH AVE, COHEN CHILDREN'S MEDICAL CENTER
Practice Address - Street 2:
Practice Address - City:QUEENS
Practice Address - State:NY
Practice Address - Zip Code:11040
Practice Address - Country:US
Practice Address - Phone:718-470-3449
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-01
Last Update Date:2024-10-25
Deactivation Date:2024-09-06
Deactivation Code:
Reactivation Date:2024-10-25
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program