MEDICARE: DOROTHY NOLAN-SHAW

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
1	235Z00000X	Speech-Language Pathologist	022779	NY

General Provider Information

NPI Number	:	1376813303
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOROTHY NOLAN-SHAW

Provider Business Mailing Address
First Line	:	110 RIDGEWOOD TER
Second Line	:
City	:	CHAPPAQUA
State	:	NY
Zip	:	10514-3520
Country	:	US
Telephone Number	:	914-658-9120
Fax Number	:

Provider Business Practice Location Address
First Line	:	110 RIDGEWOOD TER
Second Line	:
City	:	CHAPPAQUA
State	:	NY
Zip	:	10514-3520
Country	:	US
Telephone Number	:	914-658-9120
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2012
Last Update Date	:	12/10/2025

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Directions to “ DOROTHY NOLAN-SHAW ” Practice Location

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