Individual
CYNTHIA LYNN SHELLHAMMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
859 VIOLET AVE, HYDE PARK, NY 12538-3717
(845) 630-8458
Mailing address
859 VIOLET AVE, HYDE PARK, NY 12538-3717
(845) 630-8458
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
266904
NY
Other
Enumeration date
01/29/2019
Last updated
01/29/2019
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