Provider Demographics
NPI:1083274880
Name:SHEW, KATERYNA MARIELA (DMPNA, CRNA, APRN)
Entity Type:Individual
Prefix:DR
First Name:KATERYNA
Middle Name:MARIELA
Last Name:SHEW
Suffix:
Gender:F
Credentials:DMPNA, CRNA, APRN
Other - Prefix:
Other - First Name:KATERYNA
Other - Middle Name:MARIELA
Other - Last Name:SHEW
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:43 W 61ST ST APT 14C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-7616
Mailing Address - Country:US
Mailing Address - Phone:757-777-8755
Mailing Address - Fax:
Practice Address - Street 1:1275 YORK AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-6007
Practice Address - Country:US
Practice Address - Phone:212-639-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-14
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY762984163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY762984OtherREGISTERED PROFESSIONAL NURSE