Healthcare Provider Details

I. General information

NPI: 1760320733
Provider Name (Legal Business Name): SHEILA DOE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

89 BARTLETT ST
BROOKLYN NY
11206-4463
US

IV. Provider business mailing address

2087 CRESTON AVE APT 8H
BRONX NY
10453-3771
US

V. Phone/Fax

Practice location:
  • Phone: 718-282-2666
  • Fax:
Mailing address:
  • Phone: 917-609-3377
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number355836
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: