DR. SHANDURAI TEURAI TAKAVARASHA (NPI# 1114286069) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114286069 |
| Entity Type | Individual |
| Full Name | DR. SHANDURAI TEURAI TAKAVARASHA |
| Credential | M.D. |
| Practice Address |
602 Ivy St Elmira NY 14905-1646 |
| Mailing Address |
571 Saint Josephs Blvd Fl 2 Elmira NY 14901-3230 |
| Practice Telephone | 6077374577 |
| Practice Fax Number | 6077374271 |
| Mailing Telephone | 6072712050 |
| Enumeration Date | 2012-05-14 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RI0200X |
Internal Medicine Specialization: Infectious Disease |
289492 | NY | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 94 Old Short Hills Rd, Livingston, NJ 070395672 | 9733225777 |
| Street Address |
602 IVY ST |
| City | ELMIRA |
| State | NY |
| Zip Code | 14905-1646 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174598999 | Carl M. Charnetski | Internal Medicine | 602 Ivy St, 2nd Floor, Elmira, NY 14905-1646 | 2006-02-23 |
| 1366080137 | Erin Rose Terry | Physical Therapist | 602 Ivy St, Elmira, NY 14905-1646 | 2019-12-12 |
| 1578101341 | Bruce Stropko | Physical Therapist | 602 Ivy St, Elmira, NY 14905-1646 | 2019-12-12 |
| 1811416589 | Sarah J Brimmer | Nurse Practitioner | 602 Ivy St, Elmira, NY 14905-1646 | 2017-09-14 |
| 1487000923 | Ryan Matthew White | Student in an Organized Health Care Education/Training Program | 602 Ivy St, Elmira, NY 14905-1646 | 2016-05-13 |
| 1689038853 | Faisal Noorzad | Student in an Organized Health Care Education/Training Program | 602 Ivy St, Elmira, NY 14905-1646 | 2016-04-13 |
| 1598129868 | Kenneth Onuorah | Family Medicine | 602 Ivy St, Elmira, NY 14905-1646 | 2016-04-12 |
| 1063876472 | Benjamin King | Student in an Organized Health Care Education/Training Program | 602 Ivy St, Elmira, NY 14905-1646 | 2016-04-12 |
| 1386028843 | Knickerbocker Dialysis Inc | Clinic/Center | 602 Ivy St, Elmira, NY 14905-1646 | 2015-07-15 |
| 1679960066 | Donald Ray Foster | Internal Medicine | 602 Ivy St, Elmira, NY 14905-1646 | 2015-04-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780234146 | Theron Bennett | Technician | 900 West First Street, Elmira, NY 14905 | 2019-09-18 |
| 1558893792 | Zhezheng Li | Student in an Organized Health Care Education/Training Program | 600 Roe Street, Elmira, NY 14905 | 2017-03-28 |
| 1932555885 | Mitchell Pearce | Student in an Organized Health Care Education/Training Program | 602 Ivy Street, Elmira, NY 14905 | 2016-05-10 |
| 1982974465 | Chris Cook | Registered Nurse | 110 Hendy Ave, Elmira, NY 14905 | 2011-12-30 |
| 1578795290 | Richard Grinstead | Radiology | Arnot Ogden Medical Center, 600 Roe Ave, Elmira, NY 14905 | 2009-08-13 |
| 1033343967 | Janice Elaine Jackson | Registered Nurse | 1135 Hoffman Street, Elmira, NY 14905 | 2009-05-06 |
| 1598823361 | Obrien Hearing Aid Center | Hearing Aid Equipment | 227 Hoffman St, Elmira, NY 14905 | 2006-12-05 |
| 1487712634 | Robert Gordon Lyon | Dentist | 208 Walnut Street, Elmira, NY 14905 | 2006-12-04 |
| 1215009600 | Twin Tiers Dental Pllc | Dentist | 420 West Water St, Elmira, NY 14905 | 2006-11-14 |
| 1356432348 | Womens Health Services of Elmira | Obstetrics & Gynecology | 600 Fitch St Su 102, Elmira, NY 14905 | 2006-09-27 |
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| Taxonomy Code | 207RI0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Infectious Disease |
| An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003421801 | Andrea Low | Internal Medicine | 215 W 125th St Rm 302, New York, NY 10027-4426 | 2020-09-09 |
| 1114551827 | Steven Neal Miller | Internal Medicine | 29 Blair Dr, Huntington, NY 11743-2465 | 2020-03-03 |
| 1871123703 | Walter Ian Lipkin | Internal Medicine | 722 W 168th St Fl 17, New York, NY 10032-3727 | 2020-01-20 |
| 1033776307 | Debra K Strauss Md | Internal Medicine | 11 Medical Park Dr Ste 206, Pomona, NY 10970-3560 | 2019-05-22 |
| 1124590559 | Berman Infectious Disease Consultant PC | Internal Medicine | 25 Carlisle Rd, New Rochelle, NY 10804-3801 | 2018-12-25 |
| 1558838482 | Infectious Disease Consultant of Rockland, P.C. | Internal Medicine | 259 N Middletown Rd Ste 1b, Nanuet, NY 10954-1220 | 2018-10-29 |
| 1528512894 | Cordial Medical, P.C. | Internal Medicine | 100 Broadhollow Rd Ste 106, Farmingdale, NY 11735-4813 | 2016-08-04 |
| 1033508205 | Ayuda Medical, Pllc | Internal Medicine | 54 Sunrise Dr, Lynbrook, NY 11563-2920 | 2015-01-12 |
| 1659777449 | Joseph Michael Feczko | Internal Medicine | 234 E 49th St, New York, NY 10017-1502 | 2014-11-06 |
| 1669873402 | Joel Ackelsberg | Internal Medicine | 4209 28th St # Cn-22a, Long Island City, NY 11101-4130 | 2014-09-11 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.