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NPI Code Detail

MEDICARE: MS. SHAVONNE TAHIMA CASIMIR R.N

MEDICARE: MS. SHAVONNE TAHIMA CASIMIR R.N
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
1163W00000XRegistered Nurse662184-1NY

General Provider Information

NPI Number : 1689919714
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SHAVONNE TAHIMA CASIMIR R.N
Provider Business Mailing Address
First Line : 80 CLARKSON AVE APT 4H
Second Line :
City : BROOKLYN
State : NY
Zip : 11226-1924
Country : US
Telephone Number : 646-283-3223
Fax Number :
Provider Business Practice Location Address
First Line : 675 3RD AVE FL 5
Second Line :
City : NEW YORK
State : NY
Zip : 10017-5731
Country : US
Telephone Number : 212-204-5118
Fax Number : 212-973-1075
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2012
Last Update Date : 11/29/2012

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