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Individual

SHONETTE O KINGSTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
622 W 168TH ST, NEW YORK, NY 10032-3720
(212) 305-2415
Mailing address
350 LENOX RD APT 1C, BROOKLYN, NY 11226-2223
(917) 287-8294

Taxonomy

Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
346997
NY

Other

Enumeration date
01/10/2021
Last updated
01/10/2021
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