Individual
MR. PAUL BAXTER SHORTER SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRPA
Contact information
Practice address
444 BROADWAY, MENANDS, NY 12204-2887
(518) 205-3111
(518) 205-3111
Mailing address
444 BROADWAY, MENANDS, NY 12204-2887
(518) 205-3111
(518) 205-3111
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
7580
NY
Other
Enumeration date
05/12/2025
Last updated
05/12/2025
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