Provider Demographics
NPI:1376276063
Name:SHATS NP IN FAMILY HEALTH PC
Entity Type:Organization
Organization Name:SHATS NP IN FAMILY HEALTH PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHATS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-470-1334
Mailing Address - Street 1:1115 E 32ND ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-4734
Mailing Address - Country:US
Mailing Address - Phone:718-218-3674
Mailing Address - Fax:
Practice Address - Street 1:1115 E 32ND ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-4734
Practice Address - Country:US
Practice Address - Phone:718-218-3674
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-08
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty