MICHELE DEE SHACKELFORD (NPI# 1194872168) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194872168 |
| Entity Type | Individual |
| Full Name | MICHELE DEE SHACKELFORD |
| Credential | PH.D. |
| Practice Address |
1430 2nd Ave Suite 103 New York NY 10021-3313 |
| Mailing Address |
420 E 54th St Apt. 33b New York NY 10022-5179 |
| Practice Telephone | 2124344594 |
| Practice Fax Number | 2127175691 |
| Mailing Telephone | 9173220455 |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 005459 | NY | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811079940 | Michele B Shackelford | Emergency Medicine | 475 S Dobson Rd, Chandler, AZ 85224-5605 | 2006-10-19 |
| Street Address |
1430 2ND AVE SUITE 103 |
| City | NEW YORK |
| State | NY |
| Zip Code | 10021-3313 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871598847 | Pedro Ramiro Segarra | Obstetrics & Gynecology | 1430 2nd Ave, Suite 101, New York, NY 10021-3313 | 2005-06-16 |
| 1760768022 | Anat Zelmanovich | Obstetrics & Gynecology | 1430 2nd Ave, Suite 101, New York, NY 10021-3313 | 2011-10-31 |
| 1043349251 | Pediatric Head and Neck Associates, PC | Specialist | 1430 2nd Ave, Ste 110, New York, NY 10021-3313 | 2007-03-05 |
| 1417095563 | Amanda Nelson Mandel | Psychologist | 1430 2nd Ave, Suite 103, New York, NY 10021-3313 | 2007-02-01 |
| 1093866766 | Sandra Odalia Samaniego | Psychologist | 1430 2nd Ave, Suite 103, New York, NY 10021-3313 | 2007-01-16 |
| 1902963226 | Michelle Lorranine Kornbleuth | Psychologist | 1430 2nd Ave, Suite 103, New York, NY 10021-3313 | 2007-01-03 |
| 1053477869 | Linda Weingarten Scheffler | Psychologist | 1430 2nd Ave, Ste 109, New York, NY 10021-3313 | 2006-12-28 |
| 1386755015 | Laura Anne Lewis Mantell | Anesthesiology | 1430 2nd Ave, Suite 102, New York, NY 10021-3313 | 2006-08-31 |
| 1598873952 | Melissa Susan Pashcow | Ophthalmology | 1430 2nd Ave, Suite 108, New York, NY 10021-3313 | 2006-08-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720609175 | Haneen Qadourah | Student in an Organized Health Care Education/Training Program | Weillcornellinternalmedicineassociates, 505east70thstreet, Newyorkcity, NY 10021 | 2020-04-27 |
| 1114547080 | Mohd Omair Jamil | Pharmacist | 530 East 74th Street, 10281, New York, NY 10021 | 2020-04-21 |
| 1750915062 | Radoslav Jovanovic, Md and Kevin Jovanovic, Md | Obstetrics & Gynecology | 930 Fifth Avenue, Suite 3, New York, NY 10021 | 2020-02-25 |
| 1750915344 | Stacyann S Foster | Nurse Practitioner | 1305 York Avenue 2nd Floor, New York, NY 10021 | 2020-02-24 |
| 1477184547 | John Schipano | Pharmacist | Zitomer, 969 Madison Ave, New York, NY 10021 | 2020-01-28 |
| 1932741253 | Memorial Sloan Kettering Cancer Center | Pharmacy | 530 East 74 Street, Room 1101, New York, NY 10021 | 2019-10-09 |
| 1922656875 | Kouros Emami | Clinical Neuropsychologist | 525 East 71st St., 5th Floor, New York, NY 10021 | 2019-09-03 |
| 1083262539 | Uptown Surgical Services P.c | Clinic/Center | 111 East 71st Street, New York, NY 10021 | 2019-08-28 |
| 1316591209 | Siddiqi Medical P.C. | Internal Medicine | Archcare At Mary Manning Walsh Home, 1339 York Avenue, New York, NY 10021 | 2019-07-29 |
| 1942763602 | Alisha Bouzaher | Student in an Organized Health Care Education/Training Program | 439 East 71st, 1st Floor, New York, NY 10021 | 2019-04-10 |
| Find all providers in zip 10021 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922656875 | Kouros Emami | Clinical Neuropsychologist | 525 East 71st St., 5th Floor, New York, NY 10021 | 2019-09-03 |
| 1720633860 | Emily Kurlansik | Clinical Neuropsychologist | 300 W 55th St Apt 6c, New York, NY 10019-5164 | 2019-08-06 |
| 1750860144 | Linda Cristina Calderon | Clinical Neuropsychologist | 635 W 165th St Rm 633a, New York, NY 10032-3724 | 2018-08-07 |
| 1306349493 | Abhishek Jaywant | Clinical Neuropsychologist | 525 E 68th St # F-1699g, New York, NY 10065-4870 | 2018-03-14 |
| 1154829000 | Alice Brown Brandwein | Clinical Neuropsychologist | 445 Park Ave Fl 2, New York, NY 10022-8649 | 2018-01-25 |
| 1184139776 | Matthew Pagirsky | Clinical Neuropsychologist | 130 E 63rd St Apt 10a, New York, NY 10065-7338 | 2017-12-05 |
| 1538685441 | Kim Busichio | Clinical Neuropsychologist | 952 5th Ave Apt 4a, New York, NY 10075-1749 | 2017-08-22 |
| 1316467020 | Danny Tam | Clinical Neuropsychologist | Dva 423 E 23rd St, New York, NY 10010 | 2017-06-23 |
| 1376078030 | David Sukiennik | Clinical Neuropsychologist | 175 W 72nd St Apt 6g, New York, NY 10023-3209 | 2017-05-01 |
| 1982147310 | Milestones Psychology Group Pllc | Clinical Neuropsychologist | 41 Madison Ave Ste 2536, New York, NY 10010-2202 | 2016-12-03 |
| Find all providers in NEW YORK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.