Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | 279060 | NY |
NPI | 1295092070 |
---|---|
Provider Name | Dr. Shannon Michele Devore |
First Address | New York, NY 10016-3295 |
Second Address | New York, NY 10016-3295 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2012 |
Last Update Date | 02/04/2021 |