Individual
SHANIUN ISLAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8704 144TH ST, JAMAICA, NY 11435-3126
(646) 657-7789
Mailing address
8704 144TH ST, JAMAICA, NY 11435-3126
(646) 657-7789
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
08/27/2018
Last updated
08/27/2018
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