MS. Stacy Lee Shanahan, RPA-C

NPI #1639216617 in Woodside, New York

Provider Information

NPI Number: 1639216617
Entity Type: Individual
Name: MS. Stacy Lee Shanahan, RPA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: RPA-C
Enumeration Date: Jan 31, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 5718 WOODSIDE AVE
City: Woodside
State: New York
ZIP Code: 11377-3444
Phone: (718) 639-3600

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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