Individual
SHANNON BECKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
188 WOODHULL RD, HUNTINGTON, NY 11743-3743
(631) 682-8250
Mailing address
188 WOODHULL RD, HUNTINGTON, NY 11743-3743
(631) 682-8250
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
464126
NY
Other
Enumeration date
06/07/2019
Last updated
06/07/2019
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