Individual
JAMES A SHANAHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
37 CRYSTAL FARM RD, WARWICK, NY 10990-2864
(845) 986-1679
Mailing address
37 CRYSTAL FARM RD, WARWICK, NY 10990-2864
(845) 986-1679
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
173678
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01198127
—
NY
01
—
167018
MVP
—
01
—
1883
GHI/HMO
—
01
—
3C0826
HEALTHNET
—
01
—
6231379004
CIGNA
—
01
—
62721
AETNA
—
01
—
72017
GHI
—
01
—
821622
UNITED HEALTHCARE
—
01
—
YP054
OXFORD
—
Enumeration date
07/20/2006
Last updated
04/12/2012
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