Individual
SHANTEL ECCLESTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12103 234TH ST, ROSEDALE, NY 11422-1026
(347) 232-0792
Mailing address
12103 234TH ST, ROSEDALE, NY 11422-1026
(347) 232-0792
Taxonomy
Speciality
Code
Description
License number
State
163WN0002X
Neonatal Intensive Care Registered Nurse
679343
NY
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
350494
NY
Other
Enumeration date
07/21/2021
Last updated
07/21/2021
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