Shack, Victoria Elena
Shack, Victoria Elena is an individual health care provider with primary practice located at 150 N Country Rd Apt A10, Port Jefferson NY 11777-2154. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Shack, Victoria Elena can be contacted via phone (917) 324-7927.Contact Information
Primary practice address
150 N Country Rd Apt A10
Port Jefferson NY 11777-2154
Phone: (917) 324-7927
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 056759-1 | New York |
Profile Details
| NPI number | 1538427802 |
|---|---|
| LBN Legal business name | Shack, Victoria Elena |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 24th, 2012 |
| Last updated | Sep 6th, 2013 - about 11 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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