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Provider Information for 1669438941

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

YEVGENIYA SHURP MD

Gender: FEMALE

Individual NPI: 1669438941

Calendar   Last Updated:  2015-02-24
  Certification Date: 

Details

Name Value
NPI 1669438941
Enumeration Date 2006-04-25
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 130 GRAND STREET
CROTON, NY 10520
United States

Phone: 914-271-4727 | Fax: 914-271-5639
View Map External Link
Primary Practice Address 4 MORRISEY DRIVE
PUTNAM VALLEY, NY 10579
United States

Phone: 845-528-5222 | Fax: 845-528-8589
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
MEDICAID NY 01809961
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 208000000X - Pediatrics NY 207317