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NPI Code Detail

MEDICARE: ANI SHADUNTS

MEDICARE:   ANI  SHADUNTS
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
1106S00000XBehavior Technician2012405261NY

General Provider Information

NPI Number : 1568305654
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANI SHADUNTS
Provider Business Mailing Address
First Line : 211 BRIGHTON 15TH ST APT 4D
Second Line :
City : BROOKLYN
State : NY
Zip : 11235-5829
Country : US
Telephone Number : 904-887-8743
Fax Number :
Provider Business Practice Location Address
First Line : 2571 E 17TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11235-3585
Country : US
Telephone Number : 718-412-9777
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2026
Last Update Date : 04/13/2026

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Directions to “ ANI SHADUNTS ” Practice Location

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