Provider Demographics
NPI:1407240617
Name:DUPUY, SHAINA
Entity Type:Individual
Prefix:
First Name:SHAINA
Middle Name:
Last Name:DUPUY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8743 110TH ST APT 2
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11418-2308
Mailing Address - Country:US
Mailing Address - Phone:917-238-6547
Mailing Address - Fax:
Practice Address - Street 1:8743 110TH ST APT 2
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11418-2308
Practice Address - Country:US
Practice Address - Phone:917-238-6547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-25
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist