Individual
SHANEKA GREGORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
6740 4TH AVE FL 3, BROOKLYN, NY 11220-5350
(929) 455-2700
Mailing address
9821 AVENUE K, BROOKLYN, NY 11236-4407
(347) 721-5751
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F309067-1
NY
Other
Enumeration date
11/14/2019
Last updated
06/06/2022
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