Individual
SHANE MARIO ANDRE DRAKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 920-4321
Mailing address
3450 WAYNE AVE, APARTMENT 16K, BRONX, NY 10467-2510
(347) 207-7001
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
NY
Other
Enumeration date
02/02/2011
Last updated
07/21/2022
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