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 / Gastroenterology 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:
Health care specialties
| Specialty | Code | License # | 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 13th, 2026 - about 3 months 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1366443863 | NPPES |
| New York | Other | 89979 | GHI MEDICARE |
| New York | MEDICAID | 00194312 | GHI MEDICARE |
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