Healthcare Provider Details

I. General information

NPI: 1073733994
Provider Name (Legal Business Name): SHIRLEY SHAKE' TOPALIAN MA.,APRN,BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: S. SHAKE' TOPALIAN MA.,APRN,BC

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

138 W 25TH ST 6TH FLOOR SUITE 24
NEW YORK NY
10001-7405
US

IV. Provider business mailing address

305 W 13TH ST APT 4C
NEW YORK NY
10014-1217
US

V. Phone/Fax

Practice location:
  • Phone: 212-989-1846
  • Fax: 212-924-2925
Mailing address:
  • Phone: 212-924-2925
  • Fax: 212-924-2925

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number206356
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: