Provider Demographics
NPI:1831553460
Name:SHEN, STEPHANIE (MD)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:SHEN
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 1:305 7TH AVENUE
Mailing Address - Street 2:SUITE 13C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001
Mailing Address - Country:US
Mailing Address - Phone:646-647-0022
Mailing Address - Fax:646-871-6891
Practice Address - Street 1:133-38 41ST ROAD
Practice Address - Street 2:SUITE 2N
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355
Practice Address - Country:US
Practice Address - Phone:718-939-5200
Practice Address - Fax:646-871-6891
Is Sole Proprietor?:No
Enumeration Date:2016-04-10
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN62619207L00000X
CT75134207L00000X
NY306333207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology