Individual
DR. ANTHONY J SHALLASH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 HOSPITAL RD, MEDICAL AFFAIRS OFFICE, PATCHOGUE, NY 11772-4870
(631) 654-7481
(631) 447-3722
Mailing address
2852 LINDENMERE DR, MERRICK, NY 11566-4619
(516) 771-7915
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
189776
NY
Other
Enumeration date
12/12/2006
Last updated
07/09/2007
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