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Individual

CHRISTOPHER M SHACKLES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O., MPH

Contact information

Practice address
STONY BROOK UNIVERSITY HOSPITAL, 101 NICHOLS ROAD, STONY BROOK, NY 11794-0001
(631) 444-1791
(631) 444-7689
Mailing address
101 NICOLLS RD, STONY BROOK, NY 11794-0001
(631) 444-5400

Taxonomy

Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
306058-01
NY
208600000X
Surgery Physician
946244
NY

Other

Enumeration date
04/22/2014
Last updated
07/25/2023
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