Individual
MS. SHAHIDAH Z CLANTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3711 QUEENS BLVD, LONG ISLAND CITY, NY 11101-1725
(718) 361-5100
(718) 361-5169
Mailing address
3711 QUEENS BLVD, LONG ISLAND CITY, NY 11101-1725
(718) 361-5100
(718) 361-5169
Taxonomy
Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
Primary
714895-1
NY
164W00000X
Licensed Practical Nurse
295432-1
NY
Other
Enumeration date
11/30/2011
Last updated
10/12/2016
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