Healthcare Provider Details

I. General information

NPI: 1194442871
Provider Name (Legal Business Name): SHADNA LABINJO F.N.P
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2022
Last Update Date: 10/24/2022
Certification Date: 10/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 13TH ST
BROOKLYN NY
11215-4802
US

IV. Provider business mailing address

10 WESTWOOD DR APT 40
WESTBURY NY
11590-1603
US

V. Phone/Fax

Practice location:
  • Phone: 718-832-5980
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF349378
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: