person
Shannon Roesch, DPMPC
Foot & Ankle Surgery Podiatrist in Floral Park, New York
NPI 1992876239

Shannon Roesch is a Foot & Ankle Surgery Podiatrist based in Floral Park, NY and is specialized in Foot & Ankle Surgery. Shannon Roesch practices in Floral Park, NY and has the professional credentials of DPMPC. The NPI Number for Shannon Roesch is 1992876239 and holds a License No. N005991 (New York).

The current practice location address for Shannon Roesch is 242 Jericho Tpke, Floral Park, NY and can be reached out via phone at 516-488-6290 and via fax at 516-488-3172.

Location: 242 Jericho Tpke, Floral Park, NY, 11001-2147
person
Provider Profile Details
NPI Number
1992876239
Provider Name
Shannon Roesch
Credential
DPMPC
Provider Entity Type
Individual
Gender
Female
Address
242 Jericho Tpke, Floral Park, NY, 11001-2147
Phone Number
516-488-6290
Fax Number
516-488-3172
Provider Enumeration Date
11/10/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
00599165NY 01 NY 1199
6C1150 01 NY HEALTHNET
0151722 01 NY GHI
1779083 01 NY CIGNA
7444873 01 AETNA
P3722100 01 NY OXFORD
N005991 01 NY HIP
PL2751 01 NY BLUE CROSS BLUE SHIELD
institution
Provider Business Practice Location Address Details
Address
242 Jericho Tpke
City
State
Zip
11001-2147
Phone Number
516-488-6290
Fax Number
516-488-3172
person
Provider Business Mailing Address Details
Address
242 Jericho Tpke
City
State
Zip
11001-2147
Phone Number
516-488-6290
Fax Number
516-488-3172
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot & Ankle Surgery
Taxonomy
License No.
N005991 (New York)
Definition
Definition to come...
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