Shannon McCartney

Individual provider Active NPI Licensed Practical Nurse · Marlboro, NY

NPI 1952864563 · NPPES record last updated Apr 10, 2019

Key facts

NPI
1952864563
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
333341 (NY)
Practice address
1430 Route 9W
Marlboro, NY 12542-5405
Phone
(845) 275-5372
NPI assigned
Apr 10, 2019
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
333341NYMDFamily Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 333341 NY Yes

Addresses

Primary practice location

1430 Route 9W
Marlboro, NY 12542-5405

Mailing address

1430 Route 9W
Marlboro, NY 12542-5405

Other providers in Marlboro, NY

All providers in Marlboro, NY · Licensed Practical Nurse in New York

Sources for this page

Verify at the official NPI Registry.