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General NPI Number Information
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NPI Number | 1396256525
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Entity Type | Individual
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Provider Name | SHELLEY Z BI PA
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Gender | Female
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Dates
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Enumeration Date | 10/16/2017
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Last Update Date | 05/22/2023
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Provider Practice Location Address
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Address Line | 945 5TH AVE
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City | NEW YORK
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State | NY
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Zip | 10021-2661
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Country | US
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Telephone | 646-687-7600
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Fax |
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Provider Business Mailing Address
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Address Line | 6776 BOOTH ST APT 4M
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City | FOREST HILLS
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State | NY
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Zip | 11375-3112
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Country | US
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Telephone | 347-279-7475
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 58272
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 021253
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License Number State | NY
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