MEDICARE: PHILLIPA SHAND

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
1	163WI0500X	Infusion Therapy Registered Nurse	742043	NY

General Provider Information

NPI Number	:	1649130600
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHILLIPA SHAND

Provider Business Mailing Address
First Line	:	100 DARROW PL APT 6E
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10475-1865
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 DARROW PL APT 6E
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10475-1865
Country	:	US
Telephone Number	:	347-495-4784
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/13/2025
Last Update Date	:	11/13/2025

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Directions to “ PHILLIPA SHAND ” Practice Location

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