National Provider Identifier
Brian R. Shaw, D.O.
Brian R. Shaw, D.O. is listed in the NPPES registry with a primary specialty of Interventional Cardiology Physician in Ithaca, NY and a listed phone number of (215) 840-6142.
Profile Overview
- NPI
- 1578890570
- Provider Type
- Individual
- Primary Specialty
- Interventional Cardiology Physician
- Enumeration Date
- November 11, 2009
- Last Updated
- March 19, 2024
Practice Location
- 201 Dates Dr Ste 101
- Ithaca, NY 14850-1345
Phone: (215) 840-6142
Specialties
- Interventional Cardiology Physician (207RI0011X)
- Cardiovascular Disease Physician (207RC0000X)
- Internal Medicine Physician (207R00000X)
Full Record
- NPI
- 1578890570
- Entity Type
- Individual
- Last Name
- Shaw
- First Name
- Brian
- Middle Name
- R.
- Credential
- D.O.
- Mailing Street Address
- 201 Dates Dr Ste 101
- Mailing City
- Ithaca
- Mailing State
- NY
- Mailing ZIP Code
- 14850-1345
- Mailing Country
- US
- Mailing Phone
- (607) 272-0460
- Practice Street Address
- 201 Dates Dr Ste 101
- Practice City
- Ithaca
- Practice State
- NY
- Practice ZIP Code
- 14850-1345
- Practice Country
- US
- Practice Phone
- (215) 840-6142
- Enumeration Date
- November 11, 2009
- Last Updated
- March 19, 2024
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- March 19, 2024
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Interventional Cardiology Physician (207RI0011X), Cardiovascular Disease Physician (207RC0000X), Internal Medicine Physician (207R00000X)