MEDICARE: DR. JANE FRANCES MAREN SHAW M.D.

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	174231	NY

General Provider Information

NPI Number	:	1508007964
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JANE FRANCES MAREN SHAW M.D.

Provider Business Mailing Address
First Line	:	447 FORT WASHINGTON AVE
Second Line	:	APT. 61
City	:	NEW YORK
State	:	NY
Zip	:	10033-4649
Country	:	US
Telephone Number	:	917-783-9921
Fax Number	:

Provider Business Practice Location Address
First Line	:	447 FORT WASHINGTON AVE
Second Line	:	APT. 61
City	:	NEW YORK
State	:	NY
Zip	:	10033-4649
Country	:	US
Telephone Number	:	917-783-9921
Fax Number	:

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

Provider Enumeration Date	:	03/16/2009
Last Update Date	:	03/16/2009

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