Provider Demographics
NPI:1508007964
Name:SHAW, JANE FRANCES MAREN (MD)
Entity Type:Individual
Prefix:DR
First Name:JANE FRANCES
Middle Name:MAREN
Last Name:SHAW
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 1:447 FORT WASHINGTON AVE
Mailing Address - Street 2:APT. 61
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-4649
Mailing Address - Country:US
Mailing Address - Phone:917-783-9921
Mailing Address - Fax:
Practice Address - Street 1:447 FORT WASHINGTON AVE
Practice Address - Street 2:APT. 61
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-4649
Practice Address - Country:US
Practice Address - Phone:917-783-9921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-16
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174231207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine