Provider Demographics
NPI:1477870434
Name:CAROLE LYNNE SHEAR, M.D., P.C.
Entity Type:Organization
Organization Name:CAROLE LYNNE SHEAR, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SPAGNOLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-472-2890
Mailing Address - Street 1:114 E 72ND ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4245
Mailing Address - Country:US
Mailing Address - Phone:212-472-2890
Mailing Address - Fax:212-472-1971
Practice Address - Street 1:114 E 72ND ST
Practice Address - Street 2:SUITE B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4245
Practice Address - Country:US
Practice Address - Phone:212-472-2890
Practice Address - Fax:212-472-1971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-29
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY140666207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00471072Medicaid
NY24A571OtherEMPIRE BLUE CROSS BLUE SHIELD
NY00471072Medicaid
NY24A571Medicare PIN