Healthcare Provider Details

I. General information

NPI: 1053773101
Provider Name (Legal Business Name): SHANNON LEIGH MURAWSKI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2016
Last Update Date: 09/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47 NEW SCOTLAND AVE DEPT. OF INTERNAL MEDICINE
ALBANY NY
12208-3412
US

IV. Provider business mailing address

43 NEW SCOTLAND AVE DEPT OF
ALBANY NY
12208-3478
US

V. Phone/Fax

Practice location:
  • Phone: 518-262-5377
  • Fax:
Mailing address:
  • Phone: 518-262-2521
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number299349
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: