Provider Demographics
NPI:1629536651
Name:LALANI, SHAMIM A (FNP)
Entity Type:Individual
Prefix:MRS
First Name:SHAMIM
Middle Name:A
Last Name:LALANI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 SPARROW LN
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11797-3206
Mailing Address - Country:US
Mailing Address - Phone:347-418-1197
Mailing Address - Fax:
Practice Address - Street 1:9 SPARROW LN
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NY
Practice Address - Zip Code:11797-3206
Practice Address - Country:US
Practice Address - Phone:347-418-1197
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-08
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF340858363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily