Healthcare Provider Details

I. General information

NPI: 1053209981
Provider Name (Legal Business Name): MS. SHEENAH HONEY TUBIANO MURILLO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2025
Last Update Date: 06/27/2025
Certification Date: 06/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 RIVERS EDGE RD
NEW YORK NY
10035-1163
US

IV. Provider business mailing address

4168 72ND ST
WOODSIDE NY
11377-3931
US

V. Phone/Fax

Practice location:
  • Phone: 646-672-5800
  • Fax:
Mailing address:
  • Phone: 646-299-4904
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number984734
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: