Individual
DR. JACQUELYN SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
109 W 27TH ST FL 9, NEW YORK, NY 10001-6208
(212) 263-0040
(212) 263-8827
Mailing address
700 HICKSVILLE RD STE 205, BETHPAGE, NY 11714-3472
(267) 339-7843
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
298446
NY
207VE0102X
Reproductive Endocrinology Physician
Primary
298446
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/12/2015
Last updated
03/25/2025
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