ANDREA VITTORIA SHAW (NPI# 1912141904) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912141904 |
| Entity Type | Individual |
| Full Name | ANDREA VITTORIA SHAW |
| Credential | MD |
| Practice Address |
90 Presidential Plaza 3rd Fl Syracuse NY 13202 |
| Mailing Address |
251 Salina Meadows Pkwy Ste 100 Syracuse NY 13212-4516 |
| Practice Telephone | 3154645726 |
| Practice Fax Number | 3154642510 |
| Mailing Telephone | 3154642000 |
| Mailing Fax Number | 3154642010 |
| Enumeration Date | 2009-04-22 |
| Last Update Date | 2017-03-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | A124854 | CA | Allopathic & Osteopathic Physicians |
| Y | 208000000X | Pediatrics | 281937 | NY | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | A124854 | CA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194215533 | Andrea Shaw | Behavioral Analyst | 7145 Eyebright St, Las Vegas, NV 89131-8155 | 2018-05-10 |
| 1598820649 | Andrea Lyn Shaw | Chiropractor | 143 Thomas St Nw, Olympia, WA 98502-5231 | 2006-12-27 |
| 1558425603 | Andrea R. Shaw | Marriage & Family Therapist | 119 Hunters Ridge Rd, Chapel Hill, NC 27517-9017 | 2006-12-21 |
| 1851463004 | Andrea Shaw | Social Worker | 189 E Us Highway 40, Suite C, Troy, IL 62294-2262 | 2006-11-14 |
| 1114568169 | Andrea Michele Shaw | Social Worker | 401 E Mcmillan St, Cincinnati, OH 45206-1922 | 2019-10-01 |
| 1275929283 | Andrea Shaw | Occupational Therapist | 18 Western Ave, Gloucester, MA 01930-3665 | 2015-04-07 |
| 1992100192 | Andrea Shaw | Social Worker | 200 E 16th St, Apt. 10g, New York, NY 10003-3707 | 2014-10-30 |
| 1114249273 | Andrea L Shaw | Social Worker | 1611 Towne Dr, Columbia, MO 65202-2339 | 2010-02-17 |
| 1518931849 | Andrea B Shaw | Chiropractor | 8705 Perimeter Park Blvd, Suite 6, Jacksonville, FL 32216-6344 | 2006-02-14 |
| Street Address |
90 PRESIDENTIAL PLAZA 3RD FL |
| City | SYRACUSE |
| State | NY |
| Zip Code | 13202 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063412575 | James Anthony Traver | Internal Medicine | 90 Presidential Plaza, Uhcc, Adult Medicine, Syracuse, NY 13202 | 2005-07-26 |
| 1972116804 | Maya Marie Werksman | Nurse Practitioner | 90 Presidential Plaza, Syracuse, NY 13202 | 2020-08-29 |
| 1790316305 | Alexander C Hensel | Nurse Practitioner | 90 Presidential Plaza, Syracuse, NY 13202 | 2020-02-01 |
| 1164918546 | Cynthia Ann Davis | Nurse Practitioner | 90 Presidential Plaza, 3rd Fl, Syracuse, NY 13202 | 2018-07-09 |
| 1265945620 | Raechel Dick | Nurse Practitioner | 90 Presidential Plaza, Syracuse, NY 13202 | 2017-11-08 |
| 1295199545 | Joshua Bonville | Pediatrics | 90 Presidential Plaza, 3rd Fl, Syracuse, NY 13202-2240 | 2016-04-12 |
| 1588040331 | Deborah Bedford | Nurse Practitioner | 90 Presidential Plaza, 4th Floor, Syracuse, NY 13202 | 2015-08-04 |
| 1528453982 | Jessica E Mayer | Internal Medicine | 90 Presidential Plaza, 3rd Fl, Syracuse, NY 13202 | 2015-04-02 |
| 1285046508 | Rupali Singla | Family Medicine | 90 Presidential Plaza, Syracuse, NY 13202 | 2014-05-21 |
| 1124461116 | Heather Ann Mullin | Nurse Practitioner | 90 Presidential Plaza, 3rd Fl, Syracuse, NY 13202 | 2013-04-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255804456 | Lisa Blachford | Registered Nurse | 421 Montgomery St Room 80, Syracuse, NY 13202 | 2019-01-10 |
| 1851873640 | Syracuse Community Health Center, Inc. | Case Management | 819 South Salina Street, Syracuse, NY 13202 | 2018-08-29 |
| 1245739713 | Telibra Lloyd | Counselor | 375 W Onondaga St Suite 10, Syracuse, NY 13202 | 2018-02-09 |
| 1326574534 | Wendell Covell | Social Worker | 50 Presidential Plaza, Jefferson Tower Suite Ll05, Syracuse, NY 13202 | 2017-05-08 |
| 1083165005 | Candy Herbert | Counselor | 375 W. Onondaga St. Suite 10, Syracuse, NY 13202 | 2016-10-14 |
| 1427429760 | Joshua Caryl | Counselor | 319 East Water Street, Syracuse, NY 13202 | 2015-10-13 |
| 1093140956 | Jennifer B Mccaffrey | Nurse Practitioner | 421 Montgomery Street Room 80, Onondaga County Health Dept. Bureau of Disease Control, Syracuse, NY 13202 | 2013-09-11 |
| 1336581552 | Emily Renee Haggerty | Hospitalist | 500 Harrison St, 1705a, Syracuse, NY 13202 | 2013-07-30 |
| 1134470933 | Tanya Marie Harlec Mcguire | Genetic Counselor, MS | 90 Presdential Plaza Uhcc 3rd Fl., Regional Perinatal Center Suny Upstate Medical Ctr, Syracuse, NY 13202 | 2012-09-20 |
| 1104176320 | Mary Jo Maestri | Genetic Counselor, MS | 90 Presidential Plaza Uhcc- Perinatal Ceter, University Hospital/upstate Medical Center, Syracuse, NY 13202 | 2012-09-14 |
| Find all providers in zip 13202 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386194967 | Diane B Montgomery | Pediatrics | 1045 James St Ste 270, Syracuse, NY 13203-2791 | 2016-10-07 |
| 1285995324 | Jenica O'malley | Pediatrics | 90 Presidental Plaza 3rd Fl, Syracuse, NY 13202 | 2012-06-05 |
| 1487949913 | Angela Patricia Mojica Sanabria | Pediatrics | 3229 East Genesee St Ste 1, Syracuse, NY 13214 | 2011-06-13 |
| 1003105768 | David William Hansen | Pediatrics | 3229 E. Genesee St, Suite 1, Syracuse, NY 13214 | 2011-04-04 |
| 1760700108 | Christopher John Prendergast | Pediatrics | 725 Irving Ave Ste 804, Syracuse, NY 13210-1682 | 2010-05-10 |
| 1407007628 | Ahmad Ismail El Samra | Pediatrics | 600 James St, Apt 603, Syracuse, NY 13203-2254 | 2008-10-07 |
| 1235347915 | Frederick Goldberg | Pediatrics | Community General Hospital, 4900 Broad Road, Syracuse, NY 13215 | 2007-05-18 |
| 1679780308 | Juanita M Welnicki | Pediatrics | 5062 Skyline Dr, Syracuse, NY 13215-2444 | 2007-05-16 |
| 1801985262 | Nicholas T Massa | Pediatrics | 475 Irving Ave Ste 210, Syracuse, NY 13210-1529 | 2006-10-12 |
| 1992714117 | Shailaja Potdar | Pediatrics | 603 Oswego St, Syracuse, NY 13204-3127 | 2006-08-05 |
| 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.