Individual
MISS JANINE SHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPA-C
Contact information
Practice address
9711 3RD AVE, BROOKLYN, NY 11209-7702
(718) 833-1808
(718) 836-3711
Mailing address
9711 3RD AVE, BROOKLYN, NY 11209-7702
(718) 833-1808
(718) 836-3711
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
014373
NY
Other
Enumeration date
09/23/2010
Last updated
03/31/2021
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