Provider Demographics
NPI:1316411291
Name:ARMSTRONG, SHAWN L
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:L
Last Name:ARMSTRONG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4240 HUTCHINSON RIVER PKWY E APT 18B
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10475-4769
Mailing Address - Country:US
Mailing Address - Phone:347-755-3365
Mailing Address - Fax:
Practice Address - Street 1:4240 HUTCHINSON RIVER PKWY E APT 18B
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10475-4769
Practice Address - Country:US
Practice Address - Phone:347-755-3365
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-14
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker