Individual
MADONA SHAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
46 ROANOKE ST.,, STATEN ISLAND, NY 10314
(347) 610-6822
Mailing address
PO BOX 10294, STATEN ISLAND, NY 10301-0294
(347) 610-6822
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
NY
Other
Enumeration date
05/19/2020
Last updated
11/06/2023
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