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1457580839
TRACEY LEAH SHANNON
HAWTHORNE, NY
NPI
1457580839
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LA2200X Nurse Practitioner, Adult Health
(Licence: NY 305147)
Enumeration Date
2009-07-07
Last Update Date
2021-11-23
Business Address
TRACEY LEAH SHANNON N.P.
19 BRADHURST AVE STE 3850S
HAWTHORNE, NY 10532
Phone number: 914-909-6900
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Mailing Address
TRACEY LEAH SHANNON N.P.
19 BRADHURST AVE STE 3100N
HAWTHORNE, NY 10532-2140
Phone number: 914-909-9018
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