SHANNON ROESCH DPM PC NPI 1235296526

NPI Information

  • NPI: 1235296526
  • Provider Name: SHANNON ROESCH, DPM PC
  • Classification: Podiatrist - 213ES0131X
  • Specialization: Foot Surgery
  • Entity Type: Organization
  • Address: 242 JERICHO TPKE
    FLORAL PARK, NY
    ZIP 11001
  • Phone: (516) 488-6290

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NPI Details

SHANNON ROESCH, DPM PC is a foot surgery podiatrist in Floral Park, NY. SHANNON ROESCH, DPM PC NPI is 1235296526. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

242 JERICHO TPKE
FLORAL PARK, NY
ZIP 11001-147
Phone: (516) 488-6290
Fax: (516) 488-3172

The provider's authorized official is Shannon Roesch .
The authorized official title is Dr and has the following contact phone number (516) 488-6290.

The enumeration date for this NPI number is 1/3/2007 and was last updated on 12/30/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1213ES0131XPodiatristFoot SurgeryN005991NEW YORKYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1PL2751OTHERNEW YORKBLUE CROSS BLUE SHIELD
200599165NYOTHERNEW YORK1199
37444873OTHERNEW YORKAETNA
4P3722100OTHERNEW YORKOXFORD
50151722OTHERNEW YORKGHI
6N005991OTHERNEW YORKHIP
71779083OTHERNEW YORKCIGNA
86C1150OTHERNEW YORKHEALTHNET

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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