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NPI Code Detail

MEDICARE: SHASHONDA DADE

MEDICARE: SHASHONDA DADE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164W00000XLicensed Practical Nurse274742NY

General Provider Information

NPI Number : 1518284074
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHASHONDA DADE
Provider Business Mailing Address
First Line : 1704 FLATBUSH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11210-3943
Country : US
Telephone Number : 718-528-3432
Fax Number :
Provider Business Practice Location Address
First Line : 1704 FLATBUSH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11210-3943
Country : US
Telephone Number : 718-528-3432
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/23/2010
Last Update Date : 04/23/2010

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Directions to “ SHASHONDA DADE ” Practice Location

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