National Provider Identifier
Neil Frederick Shallish, M.D.
Neil Frederick Shallish, M.D. is listed in the NPPES registry with a primary specialty of Family Medicine Physician in Ithaca, NY and a listed phone number of (607) 277-4341.
Profile Overview
- NPI
- 1568494755
- Provider Type
- Individual
- Primary Specialty
- Family Medicine Physician
- Enumeration Date
- July 07, 2006
- Last Updated
- July 08, 2007
Practice Location
- 209 W State St
- Ithaca, NY 14850-5429
Phone: (607) 277-4341
Mailing Address
- 120 Larchmont Dr
- Trumansburg, NY 14886-9718
Specialties
- Family Medicine Physician (207Q00000X)
Full Record
- NPI
- 1568494755
- Entity Type
- Individual
- Last Name
- Shallish
- First Name
- Neil
- Middle Name
- Frederick
- Credential
- M.D.
- Mailing Street Address
- 120 Larchmont Dr
- Mailing City
- Trumansburg
- Mailing State
- NY
- Mailing ZIP Code
- 14886-9718
- Mailing Country
- US
- Mailing Phone
- (607) 387-5890
- Practice Street Address
- 209 W State St
- Practice City
- Ithaca
- Practice State
- NY
- Practice ZIP Code
- 14850-5429
- Practice Country
- US
- Practice Phone
- (607) 277-4341
- Enumeration Date
- July 07, 2006
- Last Updated
- July 08, 2007
- Sex
- Male
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Family Medicine Physician (207Q00000X)
- Other Identifiers
- 00705660 (NY)