Basic Information
Provider Information
NPI: 1497921027
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SHENOY
FirstName: AMBIKA
MiddleName: R.
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: P.O. BOX 191
Address2:  
City: ROCKLAND
State: DE
PostalCode: 197230191
CountryCode: US
TelephoneNumber: 3026514000
FaxNumber: 3026514945
Practice Location
Address1: 1600 ROCKLAND ROAD
Address2:  
City: WILMINGTON
State: DE
PostalCode: 198033607
CountryCode: US
TelephoneNumber: 3026514200
FaxNumber: 3026516408
Other Information
ProviderEnumerationDate: 05/04/2008
LastUpdateDate: 10/21/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2080P0214XC1-0009697DEY Allopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
2080P0214XMD442698PAN Allopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology

No ID Information.


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