Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Shannon Poulose, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1699414243

Dr. Shannon Poulose, MD is a Student in an Organized Health Care Education/Training Program in Mineola, New York. Registered with an NPI since 2022.

In the registry since
2022
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

222 Station Plz N Ste 509
Mineola, NY 11501-3893
Phone: (516) 663-2381
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1699414243
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 1, 2022
Last updated in NPPESApril 30, 2024
Certification dateJune 1, 2022

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