Individual
NANCY ANN SHAHEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1656 CHAMPLIN AVE, NEW HARTFORD, NY 13413
(315) 624-6116
(315) 624-6318
Mailing address
185 GENESEE ST, SUITE 600, UTICA, NY 13501-2102
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
209580
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01647929
—
NY
05
—
01885469
—
NY
01
—
040426014048
FIDELIS
NY
01
—
10047014
CDPHP
NY
01
—
209580-1
WC
NY
01
—
300085250
RAIL ROAD MEDICARE
NY
01
—
41996114
GHI
NY
01
—
9607833
MVP
NY
01
—
P010209580
BCBS
NY
Enumeration date
04/25/2006
Last updated
05/01/2023
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