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Individual

MS. SHANNON SEVERINO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
801 OSTRUM ST, BETHLEHEM, PA 18015-1000
(484) 658-2366
(833) 329-4059
Mailing address
801 OSTRUM ST, BETHLEHEM, PA 18015-1000
(484) 658-2366
(833) 329-4059

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
25MP00679300
NJ
363A00000X
Physician Assistant
Primary
MA057820
PA
363AM0700X
Medical Physician Assistant
Primary
1130197
PA

Other

Enumeration date
09/03/2015
Last updated
03/06/2026
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