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

MS. Shannon Elizabeth Masullo, MSCCC-SLP, IBCLC

Individual provider Specialist · NPI 1396125787

MS. Shannon Elizabeth Masullo, MSCCC-SLP, IBCLC is a Specialist in Astoria, New York. Registered with an NPI since 2015.

In the registry since
2015

Practice location Address checks out

2004 43rd St
Astoria, NY 11105-1239
Phone: (646) 772-6685
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X

Record details

NPI number1396125787
Entity typeIndividual (Type 1)
GenderFemale
Credentials MSCCC-SLP , IBCLC
Sole proprietorNo
NPI enumeratedJune 1, 2015
Last updated in NPPESApril 22, 2025
Certification dateMarch 15, 2025

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