Provider Demographics
NPI:1538496005
Name:SHTYKOVA, NATALIYA S (RN)
Entity Type:Individual
Prefix:MISS
First Name:NATALIYA
Middle Name:S
Last Name:SHTYKOVA
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 1:1815 E 17TH ST APT 2C
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-2958
Mailing Address - Country:US
Mailing Address - Phone:937-231-9767
Mailing Address - Fax:
Practice Address - Street 1:1815 E 17TH ST APT 2C
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-2958
Practice Address - Country:US
Practice Address - Phone:937-231-9767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-04
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY295267-1164W00000X
NY652090163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse