Provider Demographics
NPI:1407905185
Name:URSON, SHOSHANA (MD)
Entity Type:Individual
Prefix:
First Name:SHOSHANA
Middle Name:
Last Name:URSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 TRENCH STREET
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:ON
Mailing Address - Zip Code:L4C4Z3
Mailing Address - Country:CA
Mailing Address - Phone:905-707-1577
Mailing Address - Fax:
Practice Address - Street 1:7368 YONGE STREET
Practice Address - Street 2:APT.# 205
Practice Address - City:THORNHILL
Practice Address - State:ON
Practice Address - Zip Code:L4J8H9
Practice Address - Country:CA
Practice Address - Phone:905-707-1577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA821622084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry