Individual
MS. CAMILLE PHEONA SHAKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
7404 5TH AVE, BROOKLYN, NY 11209-2704
(718) 439-5111
Mailing address
472 GRAMATAN AVE APT I3, MOUNT VERNON, NY 10552-2900
(914) 610-0561
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
342467
NY
363LF0000X
Family Nurse Practitioner
Primary
342467
NY
Other
Enumeration date
12/16/2020
Last updated
05/17/2024
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