Provider Demographics
NPI:1538421227
Name:GHANY, SHIRLEY (ANP)
Entity type:Individual
Prefix:MRS
First Name:SHIRLEY
Middle Name:
Last Name:GHANY
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 WILLOUGHBY ST
Mailing Address - Street 2:APT 7H
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-5463
Mailing Address - Country:US
Mailing Address - Phone:347-661-6523
Mailing Address - Fax:
Practice Address - Street 1:2308 30TH AVE
Practice Address - Street 2:ASTORIA
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11102-3494
Practice Address - Country:US
Practice Address - Phone:718-224-9094
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-09
Last Update Date:2012-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF305488-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health