Provider Demographics
NPI:1679004758
Name:SHAND, AMIRH (LPN)
Entity Type:Individual
Prefix:
First Name:AMIRH
Middle Name:
Last Name:SHAND
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1091
Mailing Address - Street 2:APT 1N
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10472-0963
Mailing Address - Country:US
Mailing Address - Phone:347-495-0049
Mailing Address - Fax:
Practice Address - Street 1:1490 BOONE AVE
Practice Address - Street 2:APT 1N
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10460-5452
Practice Address - Country:US
Practice Address - Phone:347-495-0049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-21
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY327508164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse