Healthcare Provider Details

I. General information

NPI: 1801740352
Provider Name (Legal Business Name): KASHEKA SIDONEY BELL LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2026
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

194 SOUTHAVEN AVE
MASTIC NY
11950-4013
US

IV. Provider business mailing address

194 SOUTHAVEN AVE
MASTIC NY
11950-4013
US

V. Phone/Fax

Practice location:
  • Phone: 929-451-4574
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number355987
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: