Individual
BEVERLY SHAHEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSNP
Contact information
Practice address
3101 RIDGE RD W, BUILDING D, ROCHESTER, NY 14626-3249
(585) 225-1580
(585) 225-3137
Mailing address
3101 RIDGE RD W, BUILDING D, ROCHESTER, NY 14626-3249
(585) 225-1580
(585) 225-3137
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
F420136-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P019360036
EXCELLUS MANAGED CARE
NY
Enumeration date
10/23/2006
Last updated
02/17/2012
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