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1972027092
SHANELLE TASHAE GRAHAM
OCEANSIDE, NY
NPI
1972027092
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: NY 20801)
Enumeration Date
2017-07-31
Last Update Date
2017-07-31
Business Address
SHANELLE TASHAE GRAHAM PA-C
1 HEALTHY WAY
OCEANSIDE, NY 11572-1551
Phone number: 516-632-3000
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Mailing Address
SHANELLE TASHAE GRAHAM PA-C
98 PERRY ST
HEMPSTEAD, NY 11550-5220
Phone number: 347-282-0528
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