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Shaker Pediatrics PC

Pediatric Adolescent Medicine Physician in Latham, NY · enumerated 2006 · authorized official Henry Neilley, First Vice President.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1336156223

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Registry record

Entity type Organization (Type 2)
Legal business name Shaker Pediatrics PC
Practice address 10 Century Hill Drive, Latham, NY, 12110
Fax (518) 785-5708
Enumeration date Aug 2, 2006
Last updated in NPPES Aug 22, 2020

Taxonomy & classification

2080A0000X Pediatric Adolescent Medicine Physician Allopathic & Osteopathic Physicians Primary

Authorized official

Name Henry Neilley
Title First Vice President

Other identifiers

Identifier Type State Issuer
01762674 Medicaid NY -
26210 Other - MVP MARYLA WARSZAWA-AMB
000401340001 Other - BS SHEELA GRANEY MD
01260746 Medicaid NY -
26208 Other - MVP WILLIAM A PETERSEN MD
000401387001 Other - BS WILLIAM A PETERSEN MD
10002804 Other - CDPHP WM A PETERSEN MD
26207 Other - MVP HENRY NEILLEY MD
000401569001 Other - BS HENRY NEILLEY MD
10001463 Other - CDPHP HENRY NEILLEY MD
10044836 Other - CDPHP DAVID SHERWOOD MD
964787 Other - MVP SHEELA GRANEY MD
00392741 Medicaid NY -
349679 Other - MVP DAVID SHERWOOD MD
10002139 Other - CDPHP MARYLA WARSZAWA-AMB
10021167 Other - CDPHP SHEELA GRANEY MD
00962767 Medicaid NY -
01332856 Medicaid NY -
02094695 Medicaid NY -
1007 Other - CDPHP GROUP

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What type of organization is Shaker Pediatrics PC?
Shaker Pediatrics PC is registered in NPPES as a Pediatric Adolescent Medicine Physician (its primary provider taxonomy).
What is a Type 2 NPI?
A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2020-08-22.