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General NPI Number Information
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NPI Number | 1811248875
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Entity Type | Individual
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Provider Name | TYHISHA SHASON DUKES RN
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Gender | Female
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Dates
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Enumeration Date | 09/30/2012
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Last Update Date | 09/30/2012
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Provider Practice Location Address
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Address Line | 758 S OAK DR
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City | BRONX
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State | NY
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Zip | 10467-6566
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Country | US
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Telephone | 347-336-4734
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 211123
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City | WOODHAVEN
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State | NY
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Zip | 11421-6123
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Country | US
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Telephone | 347-336-4734
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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 | 163WA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Registered Nurse
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License Number | 618296
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | 618296
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number | 618296
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | 618296
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License Number State | NY
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Taxonomy #5
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 618296
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License Number State | NY
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