Provider Demographics
NPI:1932461274
Name:TURK, SHIFRA
Entity Type:Individual
Prefix:
First Name:SHIFRA
Middle Name:
Last Name:TURK
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 1:14745 75TH AVE
Mailing Address - Street 2:1G
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-2902
Mailing Address - Country:US
Mailing Address - Phone:718-866-8533
Mailing Address - Fax:
Practice Address - Street 1:14745 75TH AVE
Practice Address - Street 2:1G
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-2902
Practice Address - Country:US
Practice Address - Phone:718-866-8533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-12
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1202058174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist