Provider Demographics
NPI:1326062803
Name:WILLIAM SHAY, M.D., LLC
Entity Type:Organization
Organization Name:WILLIAM SHAY, M.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:SONTERRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-576-5700
Mailing Address - Street 1:314 W 14TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10014-5002
Mailing Address - Country:US
Mailing Address - Phone:212-620-0193
Mailing Address - Fax:
Practice Address - Street 1:314 W 14TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10014-5002
Practice Address - Country:US
Practice Address - Phone:212-620-0193
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY151526207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00980667Medicaid
NYA100000126Medicare PIN
NY00980667Medicaid