Individual ProviderShyam SundareshInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address17 E 102nd St, New York, NY 10029-5204(212) 659-8551(212) 241-0896PECOS EnrollmentBased on the most recent information from CMS, provider Shyam Sundaresh is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 6 days ago.Profile DetailsProvider ID1164927125Provider TypeIndividualFull NameSundaresh, ShyamGenderMaleSole ProprietorNoEnumeration Date3/29/2018Last Updated8/11/2021Contact InformationPractice LocationPractice Address17 E 102nd St, New York, NY 10029-5204Phone(212) 659-8551Fax(212) 831-8116Mailing LocationMailing Address1 Gustave L Levy Pl # 1118, New York, NY 10029-6504Phone(212) 241-0896FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense310418New York