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General NPI Number Information
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NPI Number | 1942010046
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Entity Type | Individual
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Provider Name | SHANDELL PAMELA HUBBARD FNP
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Gender | Female
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Dates
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Enumeration Date | 01/10/2025
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Last Update Date | 01/10/2025
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Provider Practice Location Address
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Address Line | 3709 FLATLANDS AVE
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City | BROOKLYN
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State | NY
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Zip | 11234-3507
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Country | US
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Telephone | 718-444-7766
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Fax |
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Provider Business Mailing Address
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Address Line | 10838 172ND ST
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City | JAMAICA
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State | NY
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Zip | 11433-3030
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Country | US
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Telephone | 347-547-4195
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 352827
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License Number State | NY
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