Individual
SHINELLE BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
287 N 3RD AVE, BAY SHORE, NY 11706-4109
(516) 610-8980
Mailing address
287 N 3RD AVE, BAY SHORE, NY 11706-4109
(516) 610-8980
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
742628
NY
Other
Enumeration date
10/13/2020
Last updated
10/13/2020
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