Provider Demographics
NPI:1740164045
Name:DAL, SHIKIAH SHALONDIA
Entity type:Individual
Prefix:
First Name:SHIKIAH
Middle Name:SHALONDIA
Last Name:DAL
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 1:38 WARNER ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14606-1847
Mailing Address - Country:US
Mailing Address - Phone:585-623-7039
Mailing Address - Fax:585-623-7039
Practice Address - Street 1:38 WARNER ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14606-1847
Practice Address - Country:US
Practice Address - Phone:585-623-7039
Practice Address - Fax:585-623-7039
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-01
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY942491-01163WH0200X, 163WS0121X, 163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WS0121XNursing Service ProvidersRegistered NursePlastic Surgery