Provider Demographics
NPI:1114245214
Name:BASTON, SHAMEEKA (RN)
Entity Type:Individual
Prefix:
First Name:SHAMEEKA
Middle Name:
Last Name:BASTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 N LONG BEACH AVE
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11520-1505
Mailing Address - Country:US
Mailing Address - Phone:347-335-4166
Mailing Address - Fax:
Practice Address - Street 1:314 N LONG BEACH AVE
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:NY
Practice Address - Zip Code:11520-1505
Practice Address - Country:US
Practice Address - Phone:347-335-3258
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-13
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY22655089163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse