Provider Demographics
NPI:1548504236
Name:SINGLETARY, SHAKERA
Entity type:Individual
Prefix:
First Name:SHAKERA
Middle Name:
Last Name:SINGLETARY
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 1:351 JACKSON ST
Mailing Address - Street 2:APT 3
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-3347
Mailing Address - Country:US
Mailing Address - Phone:516-306-9743
Mailing Address - Fax:
Practice Address - Street 1:351 JACKSON ST
Practice Address - Street 2:APT 3
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-3347
Practice Address - Country:US
Practice Address - Phone:516-306-9743
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-19
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY626641-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse