Shamoun, Jack

Shamoun, Jack is an individual health care provider with primary practice located at Crhp-711 Troy-Schenectady Road Suite 114, Latham NY 12110. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Nuclear Medicine, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Shamoun, Jack can be contacted via phone (518) 786-1600.

Contact Information

Primary practice address
Crhp-711 Troy-Schenectady Road Suite 114 Latham NY 12110
Phone: (518) 786-1600
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nuclear Medicine 207U00000X 107225 New York
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 107225 New York

Profile Details

NPI number 1508940354
LBN Legal business name Shamoun, Jack
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 25th, 2006
Last updated Dec 8th, 2007 - about 18 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 1508940354 NPPES
New York MEDICAID 00369466

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