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NPI Code Detail

MEDICARE: MRS. TASHALEE SHANICE MCGRATH-BLAGROVE MD

MEDICARE: MRS. TASHALEE SHANICE MCGRATH-BLAGROVE MD
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
12080N0001XNeonatal-Perinatal Medicine Physician25MA11757300NJ
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1528688728
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TASHALEE SHANICE MCGRATH-BLAGROVE MD
Provider Business Mailing Address
First Line : 475 SEAVIEW AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10305-3436
Country : US
Telephone Number : 718-226-9360
Fax Number :
Provider Business Practice Location Address
First Line : 4500 PARSONS BLVD BLDG STE 410
Second Line :
City : FLUSHING
State : NY
Zip : 11355-2205
Country : US
Telephone Number : 718-670-5535
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/17/2020
Last Update Date : 03/20/2026

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