Individual
CARLA M. SHANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
21 FAIRVIEW AVE APT L2, TUCKAHOE, NY 10707-4122
(646) 977-2245
Mailing address
21 FAIRVIEW AVE APT L2, TUCKAHOE, NY 10707-4122
(646) 977-2245
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
08/14/2023
Last updated
08/14/2023
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