MEDICARE: MS. SHAUNAI BARRY

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	1744P3200X	Prosthetics Case Management	NHYMOEYXP1	NM

General Provider Information

NPI Number	:	1588474092
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SHAUNAI BARRY

Provider Business Mailing Address
First Line	:	5608 MENAUL BLVD NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87110-3234
Country	:	US
Telephone Number	:	505-252-9998
Fax Number	:

Provider Business Practice Location Address
First Line	:	5608 MENAUL BLVD NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87110-3234
Country	:	US
Telephone Number	:	505-252-9998
Fax Number	:

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

Provider Enumeration Date	:	01/08/2025
Last Update Date	:	01/08/2025

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Directions to “ MS. SHAUNAI BARRY ” Practice Location

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