National Provider Identifier

Warren Thomas Shaw III

Warren Thomas Shaw III is listed in the NPPES registry with a primary specialty of Athletic Trainer in Ithaca, NY and a listed phone number of (607) 274-3011.

NPI 1427516871Ithaca, NYAthletic Trainer

Profile Overview

NPI
1427516871
Provider Type
Individual
Primary Specialty
Athletic Trainer
Enumeration Date
March 05, 2019
Last Updated
March 05, 2019

Practice Location

  • 953 Danby RD
  • Ithaca, NY 14850-7002

Phone: (607) 274-3011

Mailing Address

  • 2 Longview Dr
  • Clifton Park, NY 12065-2326

Specialties

  • Athletic Trainer (2255A2300X)
  • Student in an Organized Health Care Education/Training Program (390200000X)
Full Record
NPI
1427516871
Entity Type
Individual
Last Name
Shaw
First Name
Warren
Middle Name
Thomas
Name Suffix
III
Mailing Street Address
2 Longview Dr
Mailing City
Clifton Park
Mailing State
NY
Mailing ZIP Code
12065-2326
Mailing Country
US
Mailing Phone
(518) 915-0497
Practice Street Address
953 Danby RD
Practice City
Ithaca
Practice State
NY
Practice ZIP Code
14850-7002
Practice Country
US
Practice Phone
(607) 274-3011
Enumeration Date
March 05, 2019
Last Updated
March 05, 2019
Sex
Male
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Athletic Trainer (2255A2300X), Student in an Organized Health Care Education/Training Program (390200000X)