Individual
MISS DIANE SHIELDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3120 EASTERN PKWY, BALDWIN, NY 11510-4801
(646) 289-0126
Mailing address
3120 EASTERN PKWY, BALDWIN, NY 11510-4801
(646) 289-0126
Taxonomy
Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary
463140
NY
Other
Enumeration date
03/28/2017
Last updated
03/28/2017
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