Individual
DR. SHANE WILLIAM WASDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
130 EAST 77TH STREET, 2 BLACK HALL, NEW YORK, NY 10075-1007
(212) 434-2585
Mailing address
425 E 68TH ST, NEW YORK, NY 10065-6305
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
250329
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02299585
—
NY
Enumeration date
05/19/2008
Last updated
04/27/2023
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