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Contact Information

SHAWN P CANNON, DO
518 MONTAUK HWY
SUITE 102
AMAGANSETT, NY11930-2110
 Phone: 631-267-5373
 Fax: 631-267-5376
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for SHAWN P CANNON · (Male)

NPI Number 1831276286
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 11/01/2006
Last updated 07/29/2011 - About 15 years ago
Sole proprietor 1 Yes
Identifiers
  • NY License # 194468
  • NY Medicaid 01837136
Hospital affiliation(s)
  • UNIVERSITY HOSPITAL ( STONY BROOK ) - (Acute Care)
    HEALTH SCIENCES CENTER SUNY
    STONY BROOK, NY 11794
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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