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General NPI Number Information
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NPI Number | 1265954259
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Entity Type | Individual
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Provider Name | ELIZABETH MARY SHENK NP
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Gender | Female
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Dates
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Enumeration Date | 07/11/2017
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Last Update Date | 01/09/2024
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Provider Practice Location Address
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Address Line | 1650 GRAND CONCOURSE
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City | BRONX
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State | NY
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Zip | 10457-7606
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Country | US
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Telephone | 718-590-1800
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Fax |
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Provider Business Mailing Address
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Address Line | 235 W 48TH ST APT 22L
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City | NEW YORK
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State | NY
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Zip | 10036-1426
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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 | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | 702298
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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 | 342763
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License Number State | NY
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