person
Colleen Shaw, PA
Medical Physician Assistant in Johnstown, New York
NPI 1538290614

Colleen Shaw is a Medical Physician Assistant based in Johnstown, NY and is specialized in Medical. Colleen Shaw practices in Johnstown, NY and has the professional credentials of PA. The NPI Number for Colleen Shaw is 1538290614 and holds a License No. 0852001PA (New York).

The current practice location address for Colleen Shaw is 400 N Perry St, Johnstown, NY and can be reached out via phone at 518-736-1911 and via fax at 518-736-1923.

Location: 400 N Perry St, Johnstown, NY, 12095-1115
person
Provider Profile Details
NPI Number
1538290614
Provider Name
Colleen Shaw
Credential
PA
Provider Entity Type
Individual
Gender
Female
Address
400 N Perry St, Johnstown, NY, 12095-1115
Phone Number
518-736-1911
Fax Number
518-736-1923
Provider Enumeration Date
03/08/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
346851 01 NY MVP HEALTHPLAN
0852001PA 01 NY LISCENSE
000414322001 01 NY BLUE SHIELD
00473643 05 NY
institution
Provider Business Practice Location Address Details
Address
400 N Perry St
City
State
Zip
12095-1115
Phone Number
518-736-1911
Fax Number
518-736-1923
person
Provider Business Mailing Address Details
Address
400 N Perry St
City
State
Zip
12095-1115
Phone Number
518-736-1911
Fax Number
518-736-1923
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
0852001PA (New York)
Definition
Definition to come...
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