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General NPI Number Information
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NPI Number | 1033921457
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Entity Type | Individual
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Provider Name | SHANNA PEREZ-WALKER
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Gender | Female
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Dates
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Enumeration Date | 01/22/2025
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Last Update Date | 01/22/2025
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Provider Practice Location Address
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Address Line | 40 SAW MILL RIVER RD LOWR LL7
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City | HAWTHORNE
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State | NY
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Zip | 10532-1539
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Country | US
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Telephone | 347-918-2646
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Fax |
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Provider Business Mailing Address
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Address Line | 4386 BYRON AVE
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City | BRONX
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State | NY
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Zip | 10466-1517
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Country | US
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Telephone | 347-918-2646
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 345825
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License Number State | NY
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