Misra, Prem Shanker

Misra, Prem Shanker is an individual health care provider with primary practice located at 11247 Queens Blvd Ste 108, Forest Hills NY 11375-7417. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Gastroenterology. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Misra, Prem Shanker can be contacted via phone (718) 793-3838.

Contact Information

Primary practice address
11247 Queens Blvd Ste 108 Forest Hills NY 11375-7417
Phone: (718) 793-3838
Fax: (516) 352-2025
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 109522 New York
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X 109522 New York

Profile Details

NPI number 1366443863
LBN Legal business name Misra, Prem Shanker
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 9th, 2005
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366443863 NPPES
New York Other 89979 GHI MEDICARE
New York MEDICAID 00194312 GHI MEDICARE

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