| Kalyan K. Shastri M.d. Pllc | |
|
2950 Elmwood Ave Buffalo NY 14217-1304 | |
| (716) 462-4600 | |
| (716) 462-4645 |
| Full Name | Kalyan K. Shastri M.d. Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2950 Elmwood Ave, Buffalo, New York |
| Authorized Official Name and Position | Kalyan K Shastri (OWNER) |
| Authorized Official Contact | 7164624600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kalyan K. Shastri M.d. Pllc Po Box 4 Getzville NY 14068-0004 Ph: (716) 462-4600 | Kalyan K. Shastri M.d. Pllc 2950 Elmwood Ave Buffalo NY 14217-1304 Ph: (716) 462-4600 |
| NPI Number | 1477220770 |
|---|---|
| Provider Enumeration Date | 08/24/2021 |
| Last Update Date | 03/31/2025 |
| Certification Date | 03/31/2025 |
| Medicare PECOS PAC ID | 8820462831 |
|---|---|
| Medicare Enrollment ID | O20230314002228 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477220770 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084D0003X | Psychiatry & Neurology - Diagnostic Neuroimaging | (* (Not Available)) | Secondary |
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Amy L Heyden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952633059 PECOS PAC ID: 3476722505 Enrollment ID: I20110808000168 |
| Provider Name | Kalyan K Shastri |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1275794554 PECOS PAC ID: 4486808136 Enrollment ID: I20130204000481 |
| Provider Name | Syntyia L Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215408372 PECOS PAC ID: 8123366556 Enrollment ID: I20190211001670 |
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