Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 283111 | NY |
N | 111NI0900X | Internist | 283111 | NY |
Y | 207RG0300X | Geriatric Medicine | 283111 | NY |
NPI | 1124360359 |
---|---|
Provider Name | Dr. Amy Leah Shaw |
First Address | New York, NY 10065 |
Second Address | New York, NY 10065 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2013 |
Last Update Date | 09/07/2020 |