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1164967089 NPI number — KRISTEN EMMA SHONDELMYER MASTERS DEGREE

NPI Number: 1164967089
Health Care Provider/Practitioner: KRISTEN EMMA SHONDELMYER MASTERS DEGREE

Information about “1164967089” NPI (KRISTEN EMMA SHONDELMYER MASTERS DEGREE) exists in 1164967089 in HTML format HTML  |  1164967089 in plain Text format TXT  |  1164967089 in PDF (Portable Document Format) PDF  |  1164967089 in an XML format XML  formats.

NPI Number : 1164967089 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1164967089",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "SHONDELMYER",
    "FirstName": "KRISTEN",
    "MiddleName": "EMMA",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "MASTERS DEGREE",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "49 OAK ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CENTEREACH",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "11720-3840",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "516-647-2349",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "538 BROADHOLLOW RD",
    "SecondLinePracticeLocationAddress": "SUITE 202",
    "PracticeLocationAddressCityName": "MELVILLE",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "11747",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "631-385-7780",
    "PracticeLocationAddressFaxNumber": "631-385-7795",
    "EnumerationDate": "01/01/2017",
    "LastUpdateDate": "08/28/2018",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "174400000X",
        "TaxonomyName": "Specialist",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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