Individual
DIANA SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2888 ONEIDA ST, SAUQUOIT, NY 13456-3110
(315) 732-0660
(315) 737-5220
Mailing address
2888 ONEIDA ST, SAUQUOIT, NY 13456-3110
(315) 732-0660
(315) 737-5220
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F330568-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01968905
—
NY
Enumeration date
10/28/2005
Last updated
09/25/2012
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