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Individual
SHANNON M MOONEY
Active
Individual
SHANNON M MOONEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PAC
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
013006-1
NY
363A00000X
Physician Assistant
13006
NY
Other
Enumeration date
11/24/2008
Last updated
07/03/2023
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