Provider Demographics
NPI:1851976013
Name:RAZAMONI, SHAMIMA (FNP-BC)
Entity Type:Individual
Prefix:
First Name:SHAMIMA
Middle Name:
Last Name:RAZAMONI
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 FORBELL ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11208-3009
Mailing Address - Country:US
Mailing Address - Phone:917-291-1338
Mailing Address - Fax:
Practice Address - Street 1:154 FORBELL ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11208-3009
Practice Address - Country:US
Practice Address - Phone:917-291-1338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-09
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF347062-01363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily