Provider Demographics
NPI:1972975712
Name:RAMSAHAI-MARTIN, SHADE AMOY (RN)
Entity Type:Individual
Prefix:
First Name:SHADE
Middle Name:AMOY
Last Name:RAMSAHAI-MARTIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:232 SUMMIT HILL DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14612-3830
Mailing Address - Country:US
Mailing Address - Phone:585-576-5879
Mailing Address - Fax:
Practice Address - Street 1:178 MILFORD ST APT 28
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14615-1802
Practice Address - Country:US
Practice Address - Phone:585-576-5879
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-20
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY324015164W00000X
NY910507163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse