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General NPI Number Information
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NPI Number | 1134597040
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Entity Type | Individual
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Provider Name | SHIRLEY OHEVSHALOM FNP
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Gender | Female
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Dates
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Enumeration Date | 09/09/2015
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Last Update Date | 02/25/2021
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Provider Practice Location Address
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Address Line | 1983 MARCUS AVE
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City | NEW HYDE PARK
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State | NY
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Zip | 11042-2000
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Country | US
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Telephone | 516-326-5600
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Fax |
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Provider Business Mailing Address
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Address Line | 19 CARRIAGE RD
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City | GREAT NECK
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State | NY
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Zip | 11024-1445
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Country | US
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Telephone |
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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 | 347071
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F347071-01
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 163WS0200X
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Taxonomy Name | School Registered Nurse
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License Number | 627812
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License Number State | NY
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