Healthcare Provider Details

I. General information

NPI: 1154279032
Provider Name (Legal Business Name): MS. FARANGISS SHAYE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2026
Last Update Date: 03/17/2026
Certification Date: 03/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16808 UNION TPKE
FRESH MEADOWS NY
11366-1312
US

IV. Provider business mailing address

16808 UNION TPKE
FRESH MEADOWS NY
11366-1312
US

V. Phone/Fax

Practice location:
  • Phone: 718-480-6411
  • Fax:
Mailing address:
  • Phone: 917-756-5320
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number039662-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: