Shelly Pasquarelli, RN

Individual provider Active NPI School Registered Nurse · Marcy, NY

NPI 1023361995 · NPPES record last updated Oct 17, 2012

Key facts

NPI
1023361995
Entity type
Individual (NPI type 1)
Primary specialty
School Registered Nurse 163WS0200X
License
399180-1 (NY)
Practice address
9479 Maynard Drive
Marcy, NY 13403
Phone
(315) 266-3424
Fax
(315) 735-3358
NPI assigned
Oct 17, 2012
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
399180-1NYMDSchool Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Whitesboro Central School Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 399180-1 NY Yes

Addresses

Primary practice location

9479 Maynard Drive
Marcy, NY 13403

Mailing address

67 Whitesboro St
Yorkville, NY 13495-1313
Phone (315) 266-3424

Other providers in Marcy, NY

All providers in Marcy, NY · School Registered Nurse in New York

Sources for this page

Verify at the official NPI Registry.