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NPI Code Detail

MEDICARE: MRS. SHAKEMA KOGER

MEDICARE:  MRS. SHAKEMA  KOGER
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
1164W00000XLicensed Practical Nurse317134-1NY

General Provider Information

NPI Number : 1780068510
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SHAKEMA KOGER
Provider Business Mailing Address
First Line : 11044 176TH ST
Second Line :
City : JAMAICA
State : NY
Zip : 11433-3526
Country : US
Telephone Number : 347-617-6136
Fax Number :
Provider Business Practice Location Address
First Line : 13020 89TH RD
Second Line :
City : RICHMOND HILL
State : NY
Zip : 11418-3301
Country : US
Telephone Number : 718-441-8913
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2015
Last Update Date : 07/10/2015

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Directions to “ MRS. SHAKEMA KOGER ” Practice Location

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