Individual provider · Type 1 NPI

Shanelle Tashae Graham, PA-C

Medical Physician Assistant · Oceanside, NY

NPI number 1972027092 Active

Practice location

1 Healthy Way
Oceanside, NY 11572-1551

Mailing address

98 Perry St
Hempstead, NY 11550-5220

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X20801 (NY)

Medical Physician Assistant: Definition to come...

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About NPI 1972027092

Shanelle Tashae Graham, PA-C's National Provider Identifier is 1972027092, issued on Jul 31, 2017. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Oceanside, NY. The record was last updated on Jul 31, 2017.