MS. HEIDI SHORE PA NPI 1396843421

NPI Information

NPI: 1396843421
Provider Name: MS. HEIDI SHORE, PA
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

Address:
5000 AVENUE K
BROOKLYN, NY
ZIP 11234
Phone: (718) 968-1515
Get Directions

MS. Heidi Shore, PA is a surgical physician assistant in Brooklyn, NY. MS. Heidi Shore, PA NPI is 1396843421. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

5000 AVENUE K
BROOKLYN, NY
ZIP 11234
Phone: (718) 968-1515
Fax: (718) 209-2295

The enumeration date for this NPI number is 9/20/2006 and was last updated on 7/8/2007.

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
1	363AS0400X	Physician Assistant	Surgical	002629	NEW YORK	Yes

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
1	HE2875310	MEDICARE ID-TYPE UNSPECIFIED	NEW YORK
2	00203892	MEDICAID	NEW YORK
3	NPP000	MEDICARE UPIN

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: 4/28/2024

NPI Synchronization or Removal

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