Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 260330-1 | NY |
N | 207XS0117X | Orthopaedic Spine Surgeon | 260330-1 | NY |
N | 208200000X | Surgeon | 200301052 | NC |
N | 208600000X | Surgeon | 200301052 | NC |
NPI | 1164485306 |
---|---|
Provider Name | Jian Shen |
First Address | Latham, NY 12110-1096 |
Second Address | Latham, NY 12110-1096 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2006 |
Last Update Date | 29/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I35827 | (02) |