Provider Demographics
NPI:1992960066
Name:SHINOUDA, MARGUERITE (MS, LAC)
Entity type:Individual
Prefix:
First Name:MARGUERITE
Middle Name:
Last Name:SHINOUDA
Suffix:
Gender:F
Credentials:MS, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 NEPALE DR
Mailing Address - Street 2:
Mailing Address - City:NEW PALTZ
Mailing Address - State:NY
Mailing Address - Zip Code:12561-3313
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:222 MAIN STREET
Practice Address - Street 2:
Practice Address - City:NEW PALTZ
Practice Address - State:NY
Practice Address - Zip Code:12561-1256
Practice Address - Country:US
Practice Address - Phone:845-532-4005
Practice Address - Fax:845-255-8046
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-28
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000867208D00000X, 171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice