Provider Demographics
NPI:1518500735
Name:THEN, SHIRLEY ZAIR (NP-BC, NP-C)
Entity type:Individual
Prefix:MS
First Name:SHIRLEY
Middle Name:ZAIR
Last Name:THEN
Suffix:
Gender:F
Credentials:NP-BC, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 MADISON AVE FL 5
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-1600
Mailing Address - Country:US
Mailing Address - Phone:646-272-9084
Mailing Address - Fax:
Practice Address - Street 1:511 W 157TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-5058
Practice Address - Country:US
Practice Address - Phone:212-781-7979
Practice Address - Fax:212-781-7963
Is Sole Proprietor?:No
Enumeration Date:2019-10-21
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR23221800163W00000X
NY762433163W00000X
NY315794164W00000X
NY351160363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner