Shannon Phan

NPI 1063368272 · on the registry since 2026 · sole proprietor

Practice

Address: 4000 Medical Center Drive
Suite 504
Fayetteville, NY 13066
Phone: (315) 329-2650
Organisation at this address: Fateh Supply Inc
Tuscon Supply Inc
Syracuse Supply Inc
William Tucker Md Pllc
Sall Sleep Medicine Pllc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 35

Registry record

Primary taxonomy: 101YM0800X
101YM0800X
Licence states on file: NY
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2026-03-09

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New York