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NPI Code Detail

MEDICARE: SHANELLE BAILEY RN

MEDICARE: SHANELLE BAILEY RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse925369NY

General Provider Information

NPI Number : 1457207722
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANELLE BAILEY RN
Provider Business Mailing Address
First Line : 3320 AVENUE H APT 5R
Second Line :
City : BROOKLYN
State : NY
Zip : 11210-3319
Country : US
Telephone Number : 917-517-1462
Fax Number :
Provider Business Practice Location Address
First Line : 2811 QUEENS PLZ N FL 5
Second Line :
City : LONG ISLAND CITY
State : NY
Zip : 11101-4172
Country : US
Telephone Number : 718-391-8300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2026
Last Update Date : 03/09/2026

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