Healthcare Provider Details

I. General information

NPI: 1093637522
Provider Name (Legal Business Name): SHANNELL HOWARD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 TERRACE AVE APT 213
HEMPSTEAD NY
11550-2321
US

IV. Provider business mailing address

100 TERRACE AVE APT 213
HEMPSTEAD NY
11550-2321
US

V. Phone/Fax

Practice location:
  • Phone: 934-256-5270
  • Fax:
Mailing address:
  • Phone: 934-256-5270
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: