Individual
LOIS SHALLOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
300 COMMUNITY DR, MANHASSET, NY 11030-3816
(516) 334-0260
Mailing address
300 COMMUNITY DR, MANHASSET, NY 11030-3816
(516) 334-0260
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
609076
NY
363LA2200X
Adult Health Nurse Practitioner
307485
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
406523
NY
Other
Enumeration date
08/12/2015
Last updated
02/11/2025
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