Provider Demographics
NPI:1255379509
Name:SHAW, HOWARD T I (MD)
Entity type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:T
Last Name:SHAW
Suffix:I
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 E 67TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-5962
Mailing Address - Country:US
Mailing Address - Phone:212-517-9048
Mailing Address - Fax:212-517-2847
Practice Address - Street 1:53 E 67TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-5962
Practice Address - Country:US
Practice Address - Phone:212-517-9048
Practice Address - Fax:212-517-2847
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY192649174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY50Z971Medicare ID - Type Unspecified
NYG93245Medicare UPIN