Leo J Shea III, PH.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

0136581 Issued in NY

Practice address

201 E 28TH St
#1D
New York, NY 10016-8538

Phone

(212) 951-4545

Fax

(212) 842-0731

NPI assigned

Jul 20, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1184889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184889600000",
    "number": "1023218799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 E 31ST ST",
            "address_2": "#22C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100169500",
            "telephone_number": "212-951-4545",
            "fax_number": "212-842-0731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E 28TH ST",
            "address_2": "#1D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100168538",
            "telephone_number": "212-951-4545",
            "fax_number": "212-842-0731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEA",
        "first_name": "LEO",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-20",
        "last_updated": "2007-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NY",
            "license": "0136581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cristina Shea, LCSW
• Deborah Lee Shea, MSED
• Devlin Shea
• James O'Mara Shea
• Kathleen Shea, LCSWR
• Molly Rebecca Shea
• Stacey M Shea, M.A., CCC-SLP
• Steven J.C. Shea, M.D.
• Judy Sheahan, MA,ED.S.
• Carlyn Shear, RD

• Clinical Neuropsychologist in New York, NY
• Providers in New York, NY by specialty
• Clinical Neuropsychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.