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1245953959
SHASTA TREADWAY
WALTON, NY
NPI
1245953959
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: NY 404416)
Enumeration Date
2022-09-19
Last Update Date
2022-09-19
Business Address
SHASTA TREADWAY PMHNP
2 TITUS PL
WALTON, NY 13856-1455
Phone number: 607-865-2400
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Mailing Address
SHASTA TREADWAY PMHNP
1 TITUS PL
WALTON, NY 13856-1457
Phone number:
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