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Individual

EMILIA SHIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
450 CLARKSON AVE # 49, BROOKLYN, NY 11203-2012
(718) 270-2978
Mailing address
800 WASHINGTON ST, BOSTON, MA 02111-1552
(617) 636-5000
(617) 636-8391

Taxonomy

Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
269430
FM
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
110121271A
MA
01
S400365865
MEDICARE
MA
Enumeration date
09/20/2012
Last updated
12/20/2021
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