MEDICARE: CRAIG LOUISE SHEFLIN D.O.

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	207Q00000X	Family Medicine Physician	219347	NY

General Provider Information

NPI Number	:	1588760235
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRAIG LOUISE SHEFLIN D.O.

Provider Business Mailing Address
First Line	:	15 MUNRO BLVD
Second Line	:
City	:	VALLEY STREAM
State	:	NY
Zip	:	11581-3304
Country	:	US
Telephone Number	:	516-791-5800
Fax Number	:	516-837-3999

Provider Business Practice Location Address
First Line	:	15 MUNRO BLVD
Second Line	:
City	:	VALLEY STREAM
State	:	NY
Zip	:	11581-3304
Country	:	US
Telephone Number	:	516-791-5800
Fax Number	:	516-837-3999

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

Provider Enumeration Date	:	09/16/2006
Last Update Date	:	12/03/2012

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