Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 239113 | NY |
Y | 2080P0208X | Pediatric Infectious Diseases | 239113 | NY |
NPI | 1144484536 |
---|---|
Provider Name | Gail F Shust |
First Address | New York, NY 10029 |
Second Address | New York, NY 10029-6500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2008 |
Last Update Date | 24/01/2013 |