Individual
MEGAN SHOFKOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4102 VESTAL RD, VESTAL, NY 13850-3531
(607) 296-5579
Mailing address
4102 VESTAL RD, VESTAL, NY 13850-3531
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
0117711
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0117711
—
NY
Enumeration date
05/25/2021
Last updated
05/25/2021
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