Organization
SHANNON ROESCH, DPM PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON ROESCH MD (DR)
(516) 488-6290
Entity
Organization
Contact information
Practice address
242 JERICHO TPKE, FLORAL PARK, NY 11001-2147
(516) 488-6290
(516) 488-3172
Mailing address
242 JERICHO TPKE, FLORAL PARK, NY 11001-2147
(516) 488-6290
(516) 488-3172
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
N005991
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00599165NY
1199
NY
01
—
0151722
GHI
NY
01
—
1779083
CIGNA
NY
01
—
6C1150
HEALTHNET
NY
01
—
7444873
AETNA
NY
01
—
N005991
HIP
NY
01
—
P3722100
OXFORD
NY
01
—
PL2751
BLUE CROSS BLUE SHIELD
NY
Enumeration date
01/03/2007
Last updated
12/30/2019
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