Dr Corey A Shaw, DO | |
Psc 819 Box 4377, Fpo, AE 09645-0044 | |
(349) 568-23431 | |
Not Available |
Full Name | Dr Corey A Shaw |
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Gender | Male |
Speciality | Radiology - Diagnostic Radiology |
Location | Psc 819 Box 4377, Fpo, Armed Forces Europe |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1720066830 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2085R0202X | Radiology - Diagnostic Radiology | 302098 (New York) | Primary |
2085R0202X | Radiology - Diagnostic Radiology | 0102203234 (Virginia) | Secondary |
Entity Name | St. Agnes Healthcare, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1144250176 PECOS PAC ID: 9830092733 Enrollment ID: O20040128001146 |
Mailing Address | Practice Location Address |
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Dr Corey A Shaw, DO 150 Sunrise Hwy, Lindenhurst, NY 11757-2539 Ph: (346) 430-46423 | Dr Corey A Shaw, DO Psc 819 Box 4377, Fpo, AE 09645-0044 Ph: (349) 568-23431 |
Dr. Jonathan Paul Cutting, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: Psc 819 Box 18-1, Fpo, AE 09645 Phone: 011-349-56823500 | |
Dr. Joshua Darius Nassiri, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: Psc 836, Fpo, AE 09636 Phone: 617-320-2714 | |
Dr. Matthew Daniel Burgess, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: Us Nmrtc Sigonella, Fpo, AE 09636 Phone: 314-624-4704 |