MEDICARE: MARTIN SHANSKY MD PA

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	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1437301272
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARTIN SHANSKY MD PA

Provider Business Mailing Address
First Line	:	6278 N FEDERAL HWY
Second Line	:	SUITE 113
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33308-1916
Country	:	US
Telephone Number	:	954-567-4934
Fax Number	:	954-564-1536

Provider Business Practice Location Address
First Line	:	2881 E OAKLAND PARK BLVD
Second Line	:	SUITE 104
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33306-1813
Country	:	US
Telephone Number	:	954-567-4934
Fax Number	:	954-564-1536

Authorized Official
Title or Position	:	OWNER
Name	:	MARTIN SHANSKY
Credential	:	MD
Telephone Number	:	954-567-4934

Provider Enumeration Date	:	10/10/2008
Last Update Date	:	02/25/2009

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