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Organization

COMMUNITY OB GYN ASSOCIATES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JAMES S SHANAHAN DO (CHEIF)
(845) 986-5123
Entity
Organization

Contact information

Practice address
15 MAPLE AVE, WARWICK, NY 10990-1028
(845) 986-1523
(845) 986-1488
Mailing address
PO BOX 469, WARWICK, NY 10990-0469
(845) 986-5123
(845) 986-1488

Taxonomy

Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01814699
NY
01
0202210
GHI PPO
NY
01
10856
WELLCARE
NY
01
69941
MVP HEALTH PLANS
NY
01
903803
AETNA HEALTH PLANS HMO
NY
01
C30733
HEALTHNET
NY
Enumeration date
02/13/2007
Last updated
08/22/2020
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