Individual
DR. ROY M SHANON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
616 BARDINI DR, MELVILLE, NY 11747-5264
(516) 316-0983
(631) 423-1949
Mailing address
616 BARDINI DR, MELVILLE, NY 11747-5264
(516) 316-0983
(631) 423-1949
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
175599
NY
2084N0400X
Neurology Physician
Primary
175599
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1922517598
EMBLEM HEALTH GHI
NY
01
—
1922517598
AETNA
—
01
—
1952517598
FIDELIS
NY
01
—
1952517598
1199 NATIONAL BENEFITS FUND
—
Enumeration date
10/12/2006
Last updated
01/28/2022
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