MR. BRENDAN BARRETT SHAW (NPI# 1770111817) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770111817 |
| Entity Type | Individual |
| Full Name | MR. BRENDAN BARRETT SHAW |
| Credential | PA-S |
| Practice Address |
250 Hickok Ave Syracuse NY 13206-3343 |
| Practice Telephone | 3154477449 |
| Mailing Telephone | 3154477449 |
| Enumeration Date | 2020-04-01 |
| Last Update Date | 2020-04-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
250 HICKOK AVE |
| City | SYRACUSE |
| State | NY |
| Zip Code | 13206-3343 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194336248 | Amanda E Vadala | Dietitian, Registered | 216 Conklin Ave, Syracuse, NY 13206 | 2020-08-12 |
| 1265099378 | Trina Leigh-marie Stearns | Licensed Practical Nurse | 525 Mosley Drive, Syracuse, NY 13206 | 2019-05-23 |
| 1821583436 | Jacqueline Amanda Weiner | Marriage & Family Therapist | 3532 James Street, Syracuse, NY 13206 | 2018-06-26 |
| 1447767025 | Reality Awareness Outreach Inc | Peer Specialist | 117 S Collingwood Ave, Syracuse, NY 13206 | 2018-01-04 |
| 1790296325 | Rachel Segrue | Registered Nurse | 420 Ridgewood Dt, Syracuse, NY 13206 | 2017-10-23 |
| 1013391754 | Iva Kay Peterson | Registered Nurse | 308 Nichols Ave, Syracuse, NY 13206 | 2015-07-13 |
| 1730433673 | April Hanson | Licensed Vocational Nurse | 157 South Midler Ave, Syracuse, NY 13206 | 2012-10-30 |
| 1669722237 | Kimberly Tortorici | Specialist | 1951 Caleb Avenue, Syracuse, NY 13206 | 2012-09-11 |
| 1669769394 | Janiqua M Davis | Licensed Practical Nurse | 158 Lynwood Ave, Apt. 1, Syracuse, NY 13206 | 2011-07-01 |
| 1871886960 | Gina Tornatore | Pharmacist | 1820 Teall Ave., Syracuse, NY 13206 | 2011-05-23 |
| Find all providers in zip 13206 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609475136 | Joan Sequeira | Student in an Organized Health Care Education/Training Program | 300 Audubon Pkwy Apt 95, Syracuse, NY 13224-1245 | 2020-10-26 |
| 1134728686 | Sarah Grube | Student in an Organized Health Care Education/Training Program | 5599 Thompson Rd Apt A8, Syracuse, NY 13214-1667 | 2020-10-25 |
| 1669070413 | Sarah Lynn Olszewski | Student in an Organized Health Care Education/Training Program | 451 Bryant Ave, Syracuse, NY 13204-2505 | 2020-10-14 |
| 1689281370 | Ashley Summerton | Student in an Organized Health Care Education/Training Program | 721 N Clinton St Apt 315, Syracuse, NY 13204-1255 | 2020-09-26 |
| 1811503055 | Matthew Vincent Morales I | Student in an Organized Health Care Education/Training Program | 904 Westcott St, Syracuse, NY 13210-2508 | 2020-09-22 |
| 1043826282 | Alex J Zwierzynski | Student in an Organized Health Care Education/Training Program | 172 Greenland Dr, Syracuse, NY 13208-3057 | 2020-09-22 |
| 1528674934 | Nicole Kaczor | Student in an Organized Health Care Education/Training Program | 200 Croyden Rd, Syracuse, NY 13224-1935 | 2020-09-21 |
| 1043826480 | Faustin M. Bahizi | Student in an Organized Health Care Education/Training Program | 926 Maryland Ave, Syracuse, NY 13210-2504 | 2020-09-21 |
| 1306452743 | Samantha Elizabeth Monaco | Student in an Organized Health Care Education/Training Program | 1420 Salt Springs Rd, Syracuse, NY 13214-1434 | 2020-09-21 |
| 1528686557 | Siofra Murphy | Student in an Organized Health Care Education/Training Program | 4900 Broad Rd Ste 3m, Syracuse, NY 13215-2265 | 2020-07-07 |
| Find all providers in SYRACUSE | ||||
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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.