Most Relevant Information
Provider Data
| NPI Number: | 1003290289 |
| Provider Name: | SHANTEL MACKEY |
| Entity Type: | Individual |
| Taxonomy Code: | 174400000X |
| Specialty: | Specialist |
| License Number: | 2231925 |
Most Important Dates
| Enumeration Date: | 07/16/2015 |
| Last Updated: | 07/16/2015 |
Provider Practice Location
231 E PROSPECT AVE
APT 6C
MOUNT VERNON
NY
105502366
Practice Location Phone/Fax
| Phone: | 9145636041 |
| Fax: |
Provider Mailing Location
231 E PROSPECT AVE
APT 6C
MOUNT VERNON
NY
105502366
Provider Mailing Phone/Fax
| Phone: | 9145636041 |
| Fax: |