National Provider Identifier

Edward Shanley

Edward Shanley is listed in the NPPES registry with a primary specialty of Internal Medicine Physician in Rochester, NY and a listed phone number of (516) 998-5800.

NPI 1467940122Rochester, NYInternal Medicine Physician

Profile Overview

NPI
1467940122
Provider Type
Individual
Primary Specialty
Internal Medicine Physician
Enumeration Date
April 27, 2018
Last Updated
July 14, 2021

Practice Location

  • 601 Elmwood Ave
  • Rochester, NY 14642-0001

Phone: (516) 998-5800

Specialties

  • Internal Medicine Physician (207R00000X)
Full Record
NPI
1467940122
Entity Type
Individual
Last Name
Shanley
First Name
Edward
Mailing Street Address
601 Elmwood Ave
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14642-0001
Mailing Country
US
Mailing Phone
(585) 275-7424
Practice Street Address
601 Elmwood Ave
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14642-0001
Practice Country
US
Practice Phone
(516) 998-5800
Enumeration Date
April 27, 2018
Last Updated
July 14, 2021
Sex
Male
Sole Proprietor
Yes
Taxonomy Group 1
193200000X Multi-Specialty Group
Certification Date
July 14, 2021
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Internal Medicine Physician (207R00000X)
Other Identifiers
248830877 (NY, Drivers License)