Individual
COLLEEN SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
400 N PERRY ST, JOHNSTOWN, NY 12095-1115
(518) 736-1911
(518) 736-1923
Mailing address
400 N PERRY ST, JOHNSTOWN, NY 12095-1115
(518) 736-1911
(518) 736-1923
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0852001PA
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000414322001
BLUE SHIELD
NY
05
—
00473643
—
NY
01
—
0852001PA
LISCENSE
NY
01
—
346851
MVP HEALTHPLAN
NY
Enumeration date
03/08/2007
Last updated
02/20/2012
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us