Individual
ELLEN A SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
3959 BROADWAY, COLUMBIA UNVERSITY DEPARTMENT PEDIATRIC, NEW YORK, NY 10032-1559
(212) 304-7250
(212) 544-1974
Mailing address
3959 BROADWAY, COLUMBIA UNVERSITY DEPARTMENT PEDIATRIC, NEW YORK, NY 10032-1559
(212) 304-7250
(212) 544-1974
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
F3810081
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0105678
—
NJ
05
—
02752129
—
NY
Enumeration date
05/31/2006
Last updated
07/21/2022
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