Individual
SHANNON RENEE IRISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
36 N UNION RD, WILLIAMSVILLE, NY 14221-5383
(716) 636-1470
(716) 636-1423
Mailing address
3925 SHERIDAN DR, STE 100, AMHERST, NY 14226-1738
(716) 250-6492
(716) 250-6522
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
022057
NY
Other
Enumeration date
08/09/2018
Last updated
09/13/2019
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