Heidi Shore PA

NPI 1396843421 - Physician Assistant - 363AS0400X

NPI Details
NPI 1396843421
Gender Female
Enumeration Date 09/20/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
5000 AVENUE K
BROOKLYN NY, 11234, US
Phone (718) 968-1515
Fax (718) 209-2295
Business Location
244 96 61 AVENUE DOUGLASTON NY 11362
DOUGLASTON NY, 11362, US
Phone (718) 968-1515
Fax (718) 209-2295
Toxanomy
Taxonomy Code 363AS0400X
License State New York
License Number 002629
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According to our database, Ms. Heidi Shore PA NPI is 1396843421, taxonomy code is 363AS0400X and license number is 002629, license state is located at New York. Heidi Shore PA physically located at 5000 Avenue K, Brooklyn NY, 11234. NPI Number Heidi Shore PA has the Individual type.

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1396843421 NPI number is provided on an as is basis without warranty of any kind. 1396843421 is maintained by the National Plan & Provider Enumeration System. The contents of Heidi Shore PA are for informational purposes only.