Provider Demographics
NPI:1306862677
Name:SHAER, JENNIFER (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:SHAER
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Gender:F
Credentials:MD
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Mailing Address - Street 1:68 S SERVICE RD
Mailing Address - Street 2:SUITE 350
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-2354
Mailing Address - Country:US
Mailing Address - Phone:516-945-3000
Mailing Address - Fax:516-945-3131
Practice Address - Street 1:34 COMMERCE AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:RIVERHEAD
Practice Address - State:NY
Practice Address - Zip Code:11901-3118
Practice Address - Country:US
Practice Address - Phone:631-722-8880
Practice Address - Fax:631-722-7851
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2012-10-26
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Provider Licenses
StateLicense IDTaxonomies
NY2078482080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAH38618Medicare UPIN