Healthcare Provider Details

I. General information

NPI: 1083405278
Provider Name (Legal Business Name): SHAYNA DAHAN NURSE PRACTITIONER IN PEDIATRICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2025
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2830 OGDEN DR
YORKTOWN HEIGHTS NY
10598-2737
US

IV. Provider business mailing address

72 WESTCHESTER AVE
THORNWOOD NY
10594-1118
US

V. Phone/Fax

Practice location:
  • Phone: 914-772-0855
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SHAYNA DAHAN
Title or Position: OWNER/ PROVIDER
Credential:
Phone: 914-772-0855