Provider Demographics
NPI:1356824007
Name:HAWRAMEE, SHAN (PA-C)
Entity Type:Individual
Prefix:
First Name:SHAN
Middle Name:
Last Name:HAWRAMEE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 NIAGARA ST
Mailing Address - Street 2:
Mailing Address - City:NORTH TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120-6115
Mailing Address - Country:US
Mailing Address - Phone:716-690-2001
Mailing Address - Fax:
Practice Address - Street 1:43 NIAGARA ST
Practice Address - Street 2:
Practice Address - City:NORTH TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14120-6115
Practice Address - Country:US
Practice Address - Phone:716-690-2001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-10
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022145363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant