Shattuck, Jennifer

Shattuck, Jennifer is an sole proprietor health care provider with primary practice located at 108 Education Dr Mpms Room 127, Schenectady NY 12303-1238. She recently has only one registered license in Nursing Service Providers / School, which is considered as her primary health care specialty. Shattuck, Jennifer can be contacted via phone (518) 881-3413.

Contact Information

Primary practice address
108 Education Dr Mpms Room 127 Schenectady NY 12303-1238
Phone: (518) 881-3413
Fax: (518) 881-3411
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / School 163WS0200X 516385 New York

Profile Details

NPI number 1386920304
LBN Legal business name Shattuck, Jennifer
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 24th, 2011
Last updated Oct 24th, 2011 - about 14 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 1386920304 NPPES
New York MEDICAID 01406986

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