Provider Demographics
NPI:1336979475
Name:CHRISTOPHE, SHANOMAY (BSN-RN)
Entity type:Individual
Prefix:MRS
First Name:SHANOMAY
Middle Name:
Last Name:CHRISTOPHE
Suffix:
Gender:F
Credentials:BSN-RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11729 142ND PL
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11436-1232
Mailing Address - Country:US
Mailing Address - Phone:347-564-4142
Mailing Address - Fax:
Practice Address - Street 1:371 FORT WASHINGTON AVE
Practice Address - Street 2:APT 2B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-6743
Practice Address - Country:US
Practice Address - Phone:772-224-7640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY787043163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse