Individual
SHANNON EILEEN O'MALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
148 NATURES LN, MILLER PLACE, NY 11764-3137
(631) 636-6888
Mailing address
148 NATURES LN, MILLER PLACE, NY 11764-3137
(631) 636-6888
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
260989
NY
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
260989
NY
Other
Enumeration date
06/12/2008
Last updated
06/25/2020
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