Provider Demographics
NPI:1508329095
Name:BARRESI, SHANNON (LPN)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:
Last Name:BARRESI
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:SHANNON
Other - Middle Name:
Other - Last Name:BARRESI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:84 OLD POST RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT SINAI
Mailing Address - State:NY
Mailing Address - Zip Code:11766-1102
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8 43RD ST
Practice Address - Street 2:
Practice Address - City:CENTEREACH
Practice Address - State:NY
Practice Address - Zip Code:11720-2325
Practice Address - Country:US
Practice Address - Phone:631-285-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-11
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY902105-01163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse