Healthcare Provider Details

I. General information

NPI: 1457057986
Provider Name (Legal Business Name): SHANED SPIELMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2023
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 S DEVOE AVE
YONKERS NY
10705-4728
US

IV. Provider business mailing address

24 S DEVOE AVE
YONKERS NY
10705-4728
US

V. Phone/Fax

Practice location:
  • Phone: 914-338-6800
  • Fax: 914-751-2541
Mailing address:
  • Phone: 914-338-6800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number351552
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number577697
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: