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NPI Code Detail

MEDICARE: DR. PATRICK CHUL SHIN M.D.

MEDICARE: DR. PATRICK CHUL SHIN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085B0100XBody Imaging Physician252167NY
22085R0202XDiagnostic Radiology Physician252167NY
32085U0001XDiagnostic Ultrasound Physician252167NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1407097249
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PATRICK CHUL SHIN M.D.
Provider Business Mailing Address
First Line : 155 CANAL ST
Second Line :
City : NEW YORK
State : NY
Zip : 10013-4551
Country : US
Telephone Number : 212-431-9010
Fax Number : 212-431-9010
Provider Business Practice Location Address
First Line : 155 CANAL ST
Second Line :
City : NEW YORK
State : NY
Zip : 10013-4551
Country : US
Telephone Number : 212-431-9010
Fax Number : 212-431-9010
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2009
Last Update Date : 05/12/2026

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