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General NPI Number Information
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NPI Number | 1326499591
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Entity Type | Individual
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Provider Name | SHENEKA HORNE MD
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Gender | Female
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Dates
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Enumeration Date | 06/28/2016
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Last Update Date | 03/13/2025
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Provider Practice Location Address
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Address Line | 12105 ROCKAWAY BEACH BLVD
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City | ROCKAWAY PARK
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State | NY
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Zip | 11694-1821
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Country | US
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Telephone | 718-412-9980
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Fax | 718-586-2954
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Provider Business Mailing Address
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Address Line | 736 LINCOLN AVE
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City | BROOKLYN
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State | NY
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Zip | 11208-4102
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 0101275057
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 58683
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 319341
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License Number State | NY
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