| Jana Shaw, MD | |
|
238 Arsenal St, Watertown, NY 13601-2504 | |
| (315) 782-6400 | |
| (315) 782-1330 |
| Full Name | Jana Shaw |
|---|---|
| Gender | Female |
| Speciality | Pediatrics - Pediatric Infectious Diseases |
| Location | 238 Arsenal St, Watertown, New York |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548208820 | NPI | - | NPPES |
| 02462559 | Medicaid | NY | |
| 239174 | Other | NY | LICENSE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2080P0208X | Pediatrics - Pediatric Infectious Diseases | 239174 (New York) | Primary |
| Entity Name | Pediatric Service Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770539066 PECOS PAC ID: 9931007200 Enrollment ID: O20031223000483 |
| Entity Name | Upstate Emergency Medicine, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1275589582 PECOS PAC ID: 2466443494 Enrollment ID: O20040519001106 |
| Mailing Address | Practice Location Address |
|---|---|
| Jana Shaw, MD 20830 Cagwin Rd, Watertown, NY 13601-5364 Ph: (315) 782-6400 | Jana Shaw, MD 238 Arsenal St, Watertown, NY 13601-2504 Ph: (315) 782-6400 |
Fernando Ongkingco, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 513 Washington St, Watertown, NY 13601 Phone: 315-788-2211 Fax: 315-788-0956 | |
Shari M Hogan, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 513 Washington Street, Watertown, NY 13601 Phone: 315-788-2211 Fax: 315-788-0956 | |
Dr. Stephanie Ann Oliva, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 18969 Us Route 11, Pediatric Associates Of Watertown, Watertown, NY 13601 Phone: 315-782-4391 Fax: 315-782-4387 | |
Dr. Robert Dennis Bacsik, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 435 Harris Dr, Watertown, NY 13601 Phone: 315-782-4391 Fax: 315-788-8319 | |
Dr. Ronald G Perciaccante, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 513 Washington St, Watertown, NY 13601 Phone: 315-788-2211 Fax: 315-788-0956 | |
Dr. Sandra Elizabeth Timerman, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 513 Washington St, Suite 1, Watertown, NY 13601 Phone: 315-788-2211 Fax: 315-788-0956 |