Individual provider · Type 1 NPI

Siarra Shaw, PA-C

Surgical Physician Assistant · Livingston, NJ

NPI number 1649932534 Active

Practice location

200 S Orange Ave Ste 295
Livingston, NJ 07039-5817

Other practice locations

  • 374 W 11th St, New York, NY 10014-6250 · (212) 433-0221

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant 363AS0400XNone listed
Surgical Physician Assistant 363AS0400XPA16054 (TX)
Surgical Physician Assistant Primary 363AS0400XNone listed

Surgical Physician Assistant: Definition to come...

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About NPI 1649932534

Siarra Shaw, PA-C's National Provider Identifier is 1649932534, issued on Oct 8, 2021. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Livingston, NJ. The record was last updated on Nov 2, 2026.