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Individual

JENNIFER SHAMAH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
61 EMERALD PL, ROCK HILL, NY 12775-6049
(845) 794-6999
(845) 703-6297
Mailing address
155 CRYSTAL RUN RD, MIDDLETOWN, NY 10941-4028
(845) 703-6999
(845) 703-6297

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
334198
NY
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
334198
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02654873
NY
Enumeration date
11/15/2005
Last updated
10/15/2020
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