Individual
SHANZIDA ISLAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8732 168TH PL FL 1, JAMAICA, NY 11432-3630
(929) 374-5655
Mailing address
8732 168TH PL FL 1, JAMAICA, NY 11432-3630
(929) 374-5655
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
812682
NY
Other
Enumeration date
08/11/2022
Last updated
08/11/2022
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