Provider Demographics
NPI:1376103895
Name:SHOTTS, MOLLY (PA)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:
Last Name:SHOTTS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:1414 NEWKIRK AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-6599
Mailing Address - Country:US
Mailing Address - Phone:718-759-6100
Mailing Address - Fax:718-434-0070
Practice Address - Street 1:1414 NEWKIRK AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-6599
Practice Address - Country:US
Practice Address - Phone:718-759-6100
Practice Address - Fax:718-434-0070
Is Sole Proprietor?:No
Enumeration Date:2019-06-17
Last Update Date:2019-06-17
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant