Individual
DR. KATHLEEN M SHEFNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
475 IRVING AVE, SUITE 210, SYRACUSE, NY 13210-1756
(315) 471-2646
(315) 471-1762
Mailing address
475 IRVING AVE, SUITE 210, SYRACUSE, NY 13210-1756
(315) 471-2646
(315) 471-1762
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
221218
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02212480
—
NY
01
—
040426016033
FIDELIS
—
01
—
265416
MVP INSURANCE #
—
Enumeration date
08/31/2006
Last updated
01/16/2013
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