Individual
SHANTELL E JAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
21907 143RD RD, LAURELTON, NY 11413-3114
(929) 385-5989
(205) 751-9233
Mailing address
21907 143RD RD, LAURELTON, NY 11413-3114
(929) 385-5989
(205) 751-9233
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
—
Other
Enumeration date
12/31/2025
Last updated
01/07/2026
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