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General NPI Number Information
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NPI Number | 1801758420
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Entity Type | Individual
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Provider Name | SHANNON AHERN L.AC.
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Gender | Female
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Dates
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Enumeration Date | 12/02/2025
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 2 BROOKSITE DR STE 220
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City | SMITHTOWN
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State | NY
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Zip | 11787-3492
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Country | US
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Telephone | 631-360-8100
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Fax |
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Provider Business Mailing Address
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Address Line | 31 1ST AVE
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City | EAST ISLIP
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State | NY
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Zip | 11730-2008
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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 |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 007681-01
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License Number State | NY
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