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
Phone: (518) 370-1441
Fax: (518) 395-9431
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1891761474 | NPPES |
| New York | MEDICAID | 02995513 |
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