Provider Demographics
NPI:1053055640
Name:DESHPANDE, SHWETA RAVINDRA (MD)
Entity type:Individual
Prefix:DR
First Name:SHWETA
Middle Name:RAVINDRA
Last Name:DESHPANDE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3411 WAYNE AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-2509
Mailing Address - Country:US
Mailing Address - Phone:718-920-4137
Mailing Address - Fax:718-882-8698
Practice Address - Street 1:3411 WAYNE AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2509
Practice Address - Country:US
Practice Address - Phone:718-920-4137
Practice Address - Fax:718-882-8698
Is Sole Proprietor?:No
Enumeration Date:2022-04-21
Last Update Date:2025-10-06
Deactivation Date:2023-01-18
Deactivation Code:
Reactivation Date:2023-03-13
Provider Licenses
StateLicense IDTaxonomies
NY337622207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine