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Individual

SHAKEISHA BRIGHT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
10 PINE ST, CENTRAL ISLIP, NY 11722-4126
(631) 223-5059
Mailing address
10 PINE ST, CENTRAL ISLIP, NY 11722-4126

Taxonomy

Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
343792890316E
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
447377247
NY
Enumeration date
09/29/2017
Last updated
09/29/2017
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