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NPI Code Detail

MEDICARE: KANIKA SHIELDS

MEDICARE: KANIKA SHIELDS
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
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1588347561
Entity Type Code : Individual
Provider Name (Legal Business Name) : KANIKA SHIELDS
Provider Business Mailing Address
First Line : 1 DEGRAW AVE
Second Line :
City : TEANECK
State : NJ
Zip : 07666-4094
Country : US
Telephone Number : 718-215-5311
Fax Number : 718-865-5165
Provider Business Practice Location Address
First Line : 1 DEGRAW AVE
Second Line :
City : TEANECK
State : NJ
Zip : 07666-4094
Country : US
Telephone Number : 718-215-5311
Fax Number : 718-865-5165
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2023
Last Update Date : 09/01/2023

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Directions to “ KANIKA SHIELDS ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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