Provider Demographics
NPI:1386919355
Name:MENKES, SHEYVA (RN)
Entity type:Individual
Prefix:MRS
First Name:SHEYVA
Middle Name:
Last Name:MENKES
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 1:2200 GRAVESEND NECK RD
Mailing Address - Street 2:103A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-4847
Mailing Address - Country:US
Mailing Address - Phone:718-743-5598
Mailing Address - Fax:718-332-4986
Practice Address - Street 1:2200 GRAVESEND NECK RD
Practice Address - Street 2:103A
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-4847
Practice Address - Country:US
Practice Address - Phone:718-743-5598
Practice Address - Fax:718-332-4986
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-09
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY460516163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse