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General NPI Number Information
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NPI Number | 1366659039
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Entity Type | Organization
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Legal Business Name | MATTHEW W. SHAWL, MD PC
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 04/29/2011
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Provider Practice Location Address
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Address Line | 853 BROADWAY ROOM 903
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City | NEW YORK
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State | NY
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Zip | 10003-4703
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Country | US
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Telephone | 212-787-6900
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Fax |
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Provider Business Mailing Address
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Address Line | 853 BROADWAY ROOM 903
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City | NEW YORK
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State | NY
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Zip | 10003-4703
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | MATTHEW W SHAWL
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Credential |
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Telephone | 212-787-6900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 208640
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License Number State | NY
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