Individual
SHAINA PLACIDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
440 E MAIN ST, BAY SHORE, NY 11706-8501
(631) 414-6800
Mailing address
38 HARRISON AVE, BELLPORT, NY 11713-1102
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0215751
NY
207RH0003X
Hematology & Oncology Physician
Primary
0215751
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1346753779
—
NY
Enumeration date
11/07/2017
Last updated
01/09/2020
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