Provider Demographics
NPI:1780219444
Name:FAURE, SHANI A
Entity Type:Individual
Prefix:
First Name:SHANI
Middle Name:A
Last Name:FAURE
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 1:11620 168TH ST
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11434-1730
Mailing Address - Country:US
Mailing Address - Phone:347-235-7193
Mailing Address - Fax:
Practice Address - Street 1:11620 168TH ST
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11434-1730
Practice Address - Country:US
Practice Address - Phone:347-235-7193
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-03
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator