Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0001X | Clinical Cardiac Electrophysiologist | 187122-1 | NY |
N | 2081S0010X | Sports Medicine | 187122-1 | NY |
N | 213ES0000X | Sports Medicine | 187122-1 | NY |
NPI | 1003942020 |
---|---|
Provider Name | Joseph T Shen |
First Address | Port Washington, NY 11050-3737 |
Second Address | Port Washington, NY 11050-3737 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F89633 | (02) |