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Individual

MINDY LYNN SHAFFRAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
118 NORTH COUNTRY ROAD, PORT JEFFERSON, NY 11777
(631) 473-7171
(631) 473-4605
Mailing address
118 NORTH COUNTRY ROAD, SUFFOLK OB/GYN, LLP, PORT JEFFERSON, NY 11777
(631) 473-7171
(631) 473-4605

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
167389
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
160037800
RAILROAD MEDICARE
Enumeration date
12/19/2005
Last updated
11/26/2008
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