Provider Demographics
NPI:1972889186
Name:SHEA, ERIN (UNITED STATES)
Entity Type:Individual
Prefix:MS
First Name:ERIN
Middle Name:
Last Name:SHEA
Suffix:
Gender:F
Credentials:UNITED STATES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2953 KENT RD E
Mailing Address - Street 2:
Mailing Address - City:WANTAGH
Mailing Address - State:NY
Mailing Address - Zip Code:11793-2436
Mailing Address - Country:US
Mailing Address - Phone:516-826-3028
Mailing Address - Fax:
Practice Address - Street 1:2850 N JERUSALEM RD
Practice Address - Street 2:
Practice Address - City:WANTAGH
Practice Address - State:NY
Practice Address - Zip Code:11793-1125
Practice Address - Country:US
Practice Address - Phone:516-396-2900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-01
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009550-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist