Provider Demographics
NPI:1942079769
Name:DANIEL-EDWARDS, SHEREEN
Entity Type:Individual
Prefix:
First Name:SHEREEN
Middle Name:
Last Name:DANIEL-EDWARDS
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 1:33 BONTA ST
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-2104
Mailing Address - Country:US
Mailing Address - Phone:347-484-3124
Mailing Address - Fax:
Practice Address - Street 1:1412 BROADWAY FL 21
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-9243
Practice Address - Country:US
Practice Address - Phone:718-724-2810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-20
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY814603-01163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty