Healthcare Provider Details

I. General information

NPI: 1881270569
Provider Name (Legal Business Name): SHATIKA ZENOBIA JAMES FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2021
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 OLD TARRYTOWN RD APT 608
WHITE PLAINS NY
10603-5623
US

IV. Provider business mailing address

355 OLD TARRYTOWN RD APT 608
WHITE PLAINS NY
10603-5623
US

V. Phone/Fax

Practice location:
  • Phone: 646-234-8036
  • Fax:
Mailing address:
  • Phone: 646-234-8036
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number347447
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number347447
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: