Shaw, Justin William

Shaw, Justin William is an individual health care provider with primary practice located at 3425 Vernon Blvd , Long Island City NY 11106-5121. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Nursing Service Providers / Addiction (Substance Use Disorder). Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is his primary health care specialty. Shaw, Justin William can be contacted via phone (917) 575-5662.

Contact Information

Primary practice address
3425 Vernon Blvd Long Island City NY 11106-5121
Phone: (917) 575-5662
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 403664 New York
Nursing Service Providers / Addiction (Substance Use Disorder) 163WA0400X 711620 New York

Profile Details

NPI number 1932611357
LBN Legal business name Shaw, Justin William
Credentials NP-P, PMHNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 25th, 2017
Last updated Dec 28th, 2021 - about 4 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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