Individual
SHANE EVANDER MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11835 RT 9W, WEST COXSACKIE, NY 12192-3605
(518) 264-9000
Mailing address
11835 RT 9W, WEST COXSACKIE, NY 12192-3605
(518) 264-9000
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Enumeration date
06/06/2022
Last updated
03/08/2023
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