SHAKER PEDIATRICS PC – NPI #1336156223
Pediatrics

A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.

SHAKER PEDIATRICS PC is a provider located in LATHAM, NY. NPPES has assigned the NPI number 1336156223 to SHAKER PEDIATRICS PC on August 02, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 2080A0000X from the Health Care Provider Taxonomy code set, which is classified as Pediatrics, specializing in Adolescent Medicine

The NPI profile was previously updated about 6 years ago on Aug 22, 2020. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for SHAKER PEDIATRICS PC below.

NPI Profile for
SHAKER PEDIATRICS PC

NPI Number
1336156223
Enumeration Date

(about 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
SHAKER PEDIATRICS PC
Primary location
10 CENTURY HILL DRIVE
LATHAM, NY 12110
Phone: (518) 783-5563 Fax: (518) 785-5708
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
HENRY NEILLEY
FIRST VICE PRESIDENT
Phone: (518) 783-5563
Updated
Identifiers

Identifiers for SHAKER PEDIATRICS PC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

See identifiers
DescriptionIssuerStateIdentifier
OTHERBS HENRY NEILLEY MD000401569001
OTHERBS SHEELA GRANEY MD000401340001
OTHERBS WILLIAM A PETERSEN MD000401387001
OTHERCDPHP DAVID SHERWOOD MD10044836
OTHERCDPHP GROUP1007
OTHERCDPHP HENRY NEILLEY MD10001463
OTHERCDPHP MARYLA WARSZAWA-AMB10002139
OTHERCDPHP SHEELA GRANEY MD10021167
OTHERCDPHP WM A PETERSEN MD10002804
OTHERMVP DAVID SHERWOOD MD349679
OTHERMVP HENRY NEILLEY MD26207
OTHERMVP MARYLA WARSZAWA-AMB26210
OTHERMVP SHEELA GRANEY MD964787
OTHERMVP WILLIAM A PETERSEN MD26208
MEDICAIDNY01762674
MEDICAIDNY02094695
MEDICAIDNY00392741
MEDICAIDNY01332856
MEDICAIDNY00962767
MEDICAIDNY01260746
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
2080A0000X
- Pediatrics / Adolescent Medicine (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.