Individual
SHELLY MAURO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
38 ROLLING BROOK DR, BALLSTON SPA, NY 12020-3619
(518) 885-8574
Mailing address
38 ROLLING BROOK DR, BALLSTON SPA, NY 12020-3619
(518) 885-8574
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
22 582415
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1659437630
—
NY
Enumeration date
01/25/2017
Last updated
01/25/2017
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