DAVID SHACK (NPI# 1255889978) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255889978 |
| Entity Type | Individual |
| Full Name | DAVID SHACK |
| Credential | AGPCNP-BC |
| Practice Address |
75 Maiden Ln Ste 1206 New York NY 10038-4810 |
| Practice Telephone | 2129956495 |
| Practice Fax Number | 2123796486 |
| Mailing Telephone | 2129956495 |
| Mailing Fax Number | 2123796486 |
| Enumeration Date | 2016-09-12 |
| Last Update Date | 2017-04-05 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
F307993 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811942402 | David Shack | Psychologist | 270 Farmington Ave, Suite 309, Farmington, CT 06032-1909 | 2006-05-23 |
| Street Address |
75 MAIDEN LN STE 1206 |
| City | NEW YORK |
| State | NY |
| Zip Code | 10038-4810 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508807801 | Net 30, Inc. | Home Health | 75 Maiden Ln, 7th Floor Att: Kelvin Ng, New York, NY 10038-4819 | 2006-06-09 |
| 1144702713 | Abigail Mcguire | Speech-Language Pathologist | 75 Maiden Ln, New York, NY 10038-4810 | 2018-08-30 |
| 1306326905 | Michelle Andoy | Physical Therapist | 75 Maiden Ln, New York, NY 10038-4810 | 2018-08-14 |
| 1467958496 | Lauren Hoyt | Speech-Language Pathologist | 75 Maiden Ln, New York, NY 10038-4810 | 2018-03-30 |
| 1578080834 | Margaret Hoke Johnson | Speech-Language Pathologist | 75 Maiden Ln, New York, NY 10038-4810 | 2017-08-28 |
| 1700316494 | Stephanie Viola | Physical Therapist | 75 Maiden Ln, New York, NY 10038-4810 | 2017-06-14 |
| 1194250746 | Gotham Registry Incorporated | Home Health | 75 Maiden Ln, 7th Floor, New York, NY 10038-4810 | 2017-04-20 |
| 1093253536 | A Good Place Therapy By Kerrie Thompson, Lcsw, Pllc | Social Worker | 75 Maiden Ln, Ste 346, New York, NY 10038-4810 | 2017-02-04 |
| 1699212076 | Latavia Sturdivant | Speech-Language Pathologist | 75 Maiden Ln, New York, NY 10038-4810 | 2017-01-24 |
| 1881138915 | Chana Liebe Goldberg | Speech-Language Pathologist | 75 Maiden Ln, New York, NY 10038-4810 | 2016-12-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093353575 | Jacqueline Michelle Collins | Speech-Language Pathologist | 144-176 E 128th Street, New York, NY 10038 | 2019-12-16 |
| 1013552421 | Sai Ka Tsang | Optometrist | 150 William Street, Pride Optical, New York, NY 10038 | 2019-11-08 |
| 1407412802 | Corner Chemists Pharmacy LLC | Pharmacy | 11 Henry Street, New York, NY 10038 | 2019-05-13 |
| 1235603374 | Chuan Jing Mou | Acupuncturist | 7-8 Chatham Square #805, New York, NY 10038 | 2019-01-11 |
| 1023531654 | Natalie Considine | Counselor | 75 Maiden Ln Ste 341, New York, NY 10038 | 2017-07-25 |
| 1801319199 | Cecile Bell | Registered Nurse | 15 St James Place, Apt 10 I, New York, NY 10038 | 2017-07-19 |
| 1598206088 | Jessica Moreno | Registered Nurse | 182 South Street Apt 8e, New York, NY 10038 | 2017-03-16 |
| 1801258678 | Disha Vin | Physical Therapist | 160 Broadway East Building, New York, NY 10038 | 2016-03-22 |
| 1861877110 | Andrew Zhu | Physician Assistant | 70 William Street, New York, NY 10038 | 2015-07-29 |
| 1467848770 | Bryan Andrew Roller | Anesthesiology | Columbia University Medical Center - Dept of Anesthesia, 622 West 168th Street, New York, NY 10038 | 2015-04-13 |
| Find all providers in zip 10038 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780284927 | Hannah Catan | Nurse Practitioner | 473 W 158th St Apt 10, New York, NY 10032-5361 | 2020-10-27 |
| 1932708229 | Minkyung Lee | Nurse Practitioner | 560 Main St Apt 412, New York, NY 10044-0012 | 2020-10-19 |
| 1184231797 | Tingting Chen | Nurse Practitioner | 5618 7th Ave Brooklyn, New York, NY 11220 | 2020-09-28 |
| 1407462260 | Dukenson Bigot | Nurse Practitioner | 173 East 102nd Street, Apt 3e, New York, NY 10029-5723 | 2020-09-17 |
| 1972118206 | Trisha Aloquina | Nurse Practitioner | 106 East 32nd St, 102, New York, NY 10016 | 2020-09-14 |
| 1437760196 | Chelsea Florence Curione | Nurse Practitioner | 31 Washington Sq W Fl 4, New York, NY 10011-9172 | 2020-08-14 |
| 1538779343 | Molly Smith | Nurse Practitioner | 161 Fort Washington, Herbert Irving Pavilion, New York, NY 10032-1003 | 2020-08-06 |
| 1871101360 | Elke Kraus | Nurse Practitioner | 105 E 122nd St Apt 4e, New York, NY 10035-2821 | 2020-07-21 |
| 1942825138 | Barbara Cohen Np LLC | Nurse Practitioner | 16 W 16th St Apt 7ps, New York, NY 10011-6335 | 2020-06-12 |
| 1619590692 | Shaun Sorley | Nurse Practitioner | 12 Stuyvesant Oval Apt 9g, New York, NY 10009-2219 | 2020-05-25 |
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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.