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Individual
JENNIFER J SHANAHAN
Active
Individual
JENNIFER J SHANAHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D., C.D.N.
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
003715-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0114716
GHI PROVIDER NUMBER
NY
01
—
2269089
UNITED HC PROVIDER NUMBER
NY
01
—
7483317
AETNA PROVIDER NUMBER
NY
01
—
AZ00898
MDNY PROVIDER NUMBER
NY
01
—
P2640809
OXFORD PROVIDER NUMBER
NY
Enumeration date
11/21/2006
Last updated
07/08/2007
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