MEDICARE: SHANE SHIVA NARINE

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
1	171M00000X	Case Manager/Care Coordinator	998586405	NY

General Provider Information

NPI Number	:	1548815756
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANE SHIVA NARINE

Provider Business Mailing Address
First Line	:	9114 MERRICK BLVD
Second Line	:
City	:	JAMAICA
State	:	NY
Zip	:	11432-5363
Country	:	US
Telephone Number	:	646-717-3004
Fax Number	:

Provider Business Practice Location Address
First Line	:	9114 MERRICK BLVD FL 6
Second Line	:
City	:	JAMAICA
State	:	NY
Zip	:	11432-5363
Country	:	US
Telephone Number	:	718-408-7178
Fax Number	:	718-408-7179

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2019
Last Update Date	:	12/15/2025

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Directions to “ SHANE SHIVA NARINE ” Practice Location

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