Provider Demographics
NPI:1356074298
Name:SHURIN, NATALIE DANIELLA
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:DANIELLA
Last Name:SHURIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 FOSTER AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-1809
Mailing Address - Country:US
Mailing Address - Phone:718-724-1717
Mailing Address - Fax:718-859-4688
Practice Address - Street 1:1717 FOSTER AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-1809
Practice Address - Country:US
Practice Address - Phone:718-724-1717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-07
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy