Provider Demographics
NPI:1821716366
Name:SHIMO, JOSEPH (AUD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:SHIMO
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2210 MONROE AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-2436
Mailing Address - Country:US
Mailing Address - Phone:585-442-4180
Mailing Address - Fax:585-442-4199
Practice Address - Street 1:2210 MONROE AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-2436
Practice Address - Country:US
Practice Address - Phone:585-442-4180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-19
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist