Provider Demographics
NPI:1831881168
Name:HUTCHERSON, SHELBY (PHD)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:
Last Name:HUTCHERSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:SHELBY
Other - Middle Name:
Other - Last Name:LIPES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:327 E 64TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-6704
Mailing Address - Country:US
Mailing Address - Phone:646-608-1376
Mailing Address - Fax:
Practice Address - Street 1:327 E 64TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-6704
Practice Address - Country:US
Practice Address - Phone:646-608-1376
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-24
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247ZC0005XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyClinical Laboratory Director, Non-physician