Provider Demographics
NPI:1285186130
Name:DEMAURO, SHAUN PETER (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SHAUN
Middle Name:PETER
Last Name:DEMAURO
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 OLD ORANGEBURG RD
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:NY
Mailing Address - Zip Code:10962-1157
Mailing Address - Country:US
Mailing Address - Phone:845-680-8565
Mailing Address - Fax:
Practice Address - Street 1:6 E MAIN ST
Practice Address - Street 2:
Practice Address - City:RAMSEY
Practice Address - State:NJ
Practice Address - Zip Code:07446-1944
Practice Address - Country:US
Practice Address - Phone:201-954-0228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-26
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022527103T00000X
NJ35SI00591300103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist