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General NPI Number Information
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NPI Number | 1801008040
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Entity Type | Individual
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Provider Name | SHELLY ANN UTER NP
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Gender | Female
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 374 STOCKHOLM ST
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City | BROOKLYN
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State | NY
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Zip | 11237-4006
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Country | US
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Telephone | 718-963-7272
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Fax |
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Provider Business Mailing Address
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Address Line | 42 GOSHEN ST
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City | ELMONT
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State | NY
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Zip | 11003-5025
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Country | US
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Telephone | 516-825-4235
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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 | F303119
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License Number State | NY
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