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General NPI Number Information
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NPI Number | 1528211687
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Entity Type | Individual
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Provider Name | DENISE MICHELLE SHY REGISTERED NURSE
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Gender | Female
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Dates
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Enumeration Date | 11/02/2008
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Last Update Date | 06/05/2024
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Provider Practice Location Address
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Address Line | 3000 LAKE AVE APT 1
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City | ROCHESTER
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State | NY
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Zip | 14612-5559
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Country | US
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Telephone | 610-299-6510
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Fax |
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Provider Business Mailing Address
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Address Line | 185 KENWOOD DR N APARTMENT # 334
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City | LEVITTOWN
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State | PA
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Zip | 19055-2448
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Country | US
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Telephone | 267-980-8714
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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 | 163WG0600X
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Taxonomy Name | Gerontology Registered Nurse
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License Number | RN527229L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 868896
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License Number State | NY
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