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General NPI Number Information
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NPI Number | 1528882321
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Entity Type | Individual
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Provider Name | SHIJI JOSEPH
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Gender | Female
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Dates
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Enumeration Date | 11/09/2024
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Last Update Date | 11/14/2024
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Provider Practice Location Address
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Address Line | 1000 N VILLAGE AVE
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City | ROCKVILLE CENTRE
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State | NY
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Zip | 11570-1000
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Country | US
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Telephone | 216-705-2064
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 N VILLAGE AVE
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City | ROCKVILLE CENTRE
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State | NY
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Zip | 11570-1000
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 312034
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | F312034-01
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License Number State | NY
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