Individual
MRS. SHIJA ELSAN EAPEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
23 LAURINDA DR, COMMACK, NY 11725-4503
(631) 386-8350
Mailing address
23 LAURINDA DR, COMMACK, NY 11725-4503
(631) 386-8350
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
734787
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
50150
—
NY
Enumeration date
02/05/2018
Last updated
08/30/2021
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