Provider Demographics
NPI:1003664954
Name:MUSKELLY, SHAKIMA S
Entity type:Individual
Prefix:
First Name:SHAKIMA
Middle Name:S
Last Name:MUSKELLY
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 1:1412 BROADWAY, 21ST FLOOR
Mailing Address - Street 2:SUITE 21V
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018
Mailing Address - Country:US
Mailing Address - Phone:800-883-9426
Mailing Address - Fax:
Practice Address - Street 1:1412 BROADWAY, 21ST FLOOR
Practice Address - Street 2:SUITE 21V
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018
Practice Address - Country:US
Practice Address - Phone:800-883-9426
Practice Address - Fax:929-214-4287
Is Sole Proprietor?:No
Enumeration Date:2024-05-07
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management