Shaw, Jaclyn

Shaw, Jaclyn is an individual health care provider with primary practice located at 1044 State St , Schenectady NY 12307-1508. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Shaw, Jaclyn can be contacted via phone (518) 370-1441.

Contact Information

Primary practice address
1044 State St Schenectady NY 12307-1508
Fax: (518) 395-9431
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 010310-1 New York

Profile Details

NPI number 1891761474
LBN Legal business name Shaw, Jaclyn
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 24th, 2006
Last updated Jul 21st, 2009 - about 17 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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Identifiers

StateTypeNumberIssuer
All States NPI 1891761474 NPPES
New York MEDICAID 02995513

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