Carla M. Shane

NPI #1518640762 in Tuckahoe, New York

Provider Information

NPI Number: 1518640762
Entity Type: Individual
Name: Carla M. Shane
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Early Intervention Provider Agency
Enumeration Date: Aug 14, 2023
Last Updated: Aug 14, 2023

Practice Location

Address: 21 FAIRVIEW AVE APT L2
City: Tuckahoe
State: New York
ZIP Code: 10707-4122
Phone: (646) 977-2245

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Early Intervention Provider Agency	252Y00000X	Primary

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