Shanise Dyane Siddo

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

710596 Issued in NY

Practice address

75 New Scotland Ave
Albany, NY 12208-3409

Phone

(518) 549-6616

NPI assigned

Jun 19, 2025

Last updated

Jun 19, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1750291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750291200000",
    "number": "1053208462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 WILLETT ST APT 1K",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122101016",
            "telephone_number": "607-267-8911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 NEW SCOTLAND AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083409",
            "telephone_number": "518-549-6616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDO",
        "first_name": "SHANISE",
        "middle_name": "DYANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-19",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "710596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corianna E Sichel, PHD
• Brian Sicke, NP
• Lisa G. Sickles, LMFT LMHC
• Linda Siconolfi, LPN
• Sana Noor Siddiqui, DO
• Mandeep Singh Sidhu, M.D.-M.B.A.
• Ravinderpal S Sidhu, MD
• Kara L Sidoti, PT
• Mathia Sidoti, SLP
• Barbara Siegel, LCSW

• Registered Nurse in Albany, NY
• Providers in Albany, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.