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General NPI Number Information
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NPI Number | 1821043118
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Entity Type | Individual
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Provider Name | SHELLY M. MENOLASCINO M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/24/2006
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Last Update Date | 03/31/2021
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Provider Practice Location Address
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Address Line | 7 PATCHIN PL
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City | NEW YORK
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State | NY
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Zip | 10011-8341
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Country | US
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Telephone | 212-647-9187
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Fax | 212-243-1451
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Provider Business Mailing Address
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Address Line | 37 WASHINGTON SQ W
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City | NEW YORK
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State | NY
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Zip | 10011-9181
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Country | US
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Telephone | 212-647-9187
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Fax | 212-243-1451
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 184909
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License Number State | NY
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