Shyan Jagdeo NP
Nurse Practitioner in Far Rockaway, NY. Organization (NPI-2).
NPI number1508694076
StatusActive
Last updated in NPPESJul 25, 2024
Details
- NPI
- 1508694076
- Entity type
- Organization (NPI-2)
- Legal business name
- Shyan Jagdeo NP
- Organization subpart
- No
- Enumeration date
- Jul 25, 2024
- Certification date
- Jul 25, 2024
- Last updated
- Jul 25, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | – | – | Yes |
Practice location
3224 Anchor DrFar Rockaway, NY 11691-1602
Phone 718-450-6604 · Fax 516-531-8944
Mailing address
3224 Anchor DrFar Rockaway, NY 11691-1602
Phone 718-450-6604 · Fax 516-531-8944
Authorized official
Shyan Jagdeo
President
7184506604
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