Healthcare Provider Details

I. General information

NPI: 1356027205
Provider Name (Legal Business Name): MICHELE STEPHANIE ZHOLENDZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2023
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 E 3RD ST APT 729
BROOKLYN NY
11223-5317
US

IV. Provider business mailing address

2400 E 3RD ST APT 729
BROOKLYN NY
11223-5317
US

V. Phone/Fax

Practice location:
  • Phone: 718-974-0776
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number812979
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number356438
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: