Cordova, Shannon Joan

Cordova, Shannon Joan is an individual health care provider with primary practice located at 102 Fairharbor Dr , Patchogue NY 11772-3327. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Cordova, Shannon Joan can be contacted via phone (631) 513-8019.

Contact Information

Primary practice address
102 Fairharbor Dr Patchogue NY 11772-3327
Phone: (631) 513-8019
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 2181989 New York

Profile Details

NPI number 1538421219
LBN Legal business name Cordova, Shannon Joan
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 8th, 2012
Last updated Jun 8th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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