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Individual
SHANNON ROESCH
Active
Individual
SHANNON ROESCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPM PC
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
N005991
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00599165NY
1199
NY
01
—
0151722
GHI
NY
01
—
1779083
CIGNA
NY
01
—
6C1150
HEALTHNET
NY
01
—
7444873
AETNA
—
01
—
N005991
HIP
NY
01
—
P3722100
OXFORD
NY
01
—
PL2751
BLUE CROSS BLUE SHIELD
NY
Enumeration date
11/10/2006
Last updated
12/30/2019
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