MEDICARE: PRINCE SHAMMGOD

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	106E00000X	Assistant Behavior Analyst

General Provider Information

NPI Number	:	1609735620
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PRINCE SHAMMGOD

Provider Business Mailing Address
First Line	:	749 E 231ST ST APT 6D
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10466-4136
Country	:	US
Telephone Number	:	917-443-4778
Fax Number	:

Provider Business Practice Location Address
First Line	:	749 E 231ST ST APT 6D
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10466-4136
Country	:	US
Telephone Number	:	917-443-4778
Fax Number	:

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

Provider Enumeration Date	:	01/16/2026
Last Update Date	:	01/16/2026

Similar Medicare Providers

1063684488 — MR. JOEL ANDREW GILL LPN
Practice Location Address:

4136 BRUNER AVENUE
BRONX, NY
10466-2028

Practice Phone: 516-782-3452
Practice Fax:

1639578248 — SPOTS
Practice Location Address:

450 E 146TH ST
BRONX, NY
10455-4136

Practice Phone: 646-420-8842
Practice Fax:

1902623002 — MR. SUNDAY AKINSIKU RN
Practice Location Address:

450 E 146TH ST APT 1
BRONX, NY
10455-4136

Practice Phone: 646-726-7867
Practice Fax:

1699313734 — JEREMY MARK BIENENFELD
Practice Location Address:

600 E 233RD ST
BRONX, NY
10466-2604

Practice Phone: 718-920-9177
Practice Fax:

1164652129 — SYLVIA E. OBAYUWANA
Practice Location Address:

4297 EDSON AVE
BRONX, NY
10466-1847

Practice Phone: 917-415-7647
Practice Fax:

1962194829 — GRACE RUDNICK
Practice Location Address:

600 E 233RD ST
BRONX, NY
10466-2604

Practice Phone: 718-920-9000
Practice Fax:

Directions to “ PRINCE SHAMMGOD ” 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.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.