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General NPI Number Information
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NPI Number | 1225763170
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Entity Type | Individual
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Provider Name | NICHOLE SHENE FNP
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Gender | Female
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Dates
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Enumeration Date | 07/22/2022
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Last Update Date | 09/07/2023
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Provider Practice Location Address
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Address Line | 268 CANAL ST
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City | NEW YORK
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State | NY
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Zip | 10013-3599
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Country | US
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Telephone | 212-379-6996
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Fax | 212-379-6935
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Provider Business Mailing Address
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Address Line | 125 WALKER ST, FL. 2
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City | NEW YORK
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State | NY
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Zip | 10013-3599
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Country | US
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Telephone | 212-226-8866
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Fax | 212-226-2289
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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 | F350325
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | F350325
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License Number State | NY
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