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Individual
SHIRLEY MO
Active
Individual
SHIRLEY MO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
328904
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07894246
—
NY
Enumeration date
05/19/2021
Last updated
10/29/2025
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