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Contact Information

SHAKER PEDIATRICS PC
10 CENTURY HILL DRIVE
LATHAM, NY12110
 Phone: 518-783-5563
 Fax: 518-785-5708
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Adolescent Medicine

2080A0000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for SHAKER PEDIATRICS PC · (Female)

NPI # 1336156223
Status Active
Credentials
Entity Individual
Enumeration date 08/02/2006
Last updated 08/22/2020 - About 6 years ago
Sole proprietor 1 Not specified
Identifiers
  • NY Medicaid 00392741
  • NY Medicaid 00962767
  • NY Medicaid 01260746
  • NY Medicaid 01332856
  • NY Medicaid 01762674
  • NY Medicaid 02094695
  • Other 000401569001 BS HENRY NEILLEY MD
  • Other 000401340001 BS SHEELA GRANEY MD
  • Other 000401387001 BS WILLIAM A PETERSEN MD
  • Other 10044836 CDPHP DAVID SHERWOOD MD
  • Other 1007 CDPHP GROUP
  • Other 10001463 CDPHP HENRY NEILLEY MD
  • Other 10002139 CDPHP MARYLA WARSZAWA-AMB
  • Other 10021167 CDPHP SHEELA GRANEY MD
  • Other 10002804 CDPHP WM A PETERSEN MD
  • Other 349679 MVP DAVID SHERWOOD MD
  • Other 26207 MVP HENRY NEILLEY MD
  • Other 26210 MVP MARYLA WARSZAWA-AMB
  • Other 964787 MVP SHEELA GRANEY MD
  • Other 26208 MVP WILLIAM A PETERSEN MD
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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