Shaquetta A Pantry, LPN

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

339939 Issued in NY

Practice address

12511 149TH Ave
South Ozone Park, NY 11420-3717

Phone

(631) 379-6041

NPI assigned

Jun 24, 2024

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

Other names 1

• Ms. Shaquetta A Taylor Former name

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": "1719187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1083458145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12511 149TH AVE",
            "city": "SOUTH OZONE PARK",
            "state": "NY",
            "postal_code": "114203717",
            "telephone_number": "631-379-6041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12511 149TH AVE",
            "city": "SOUTH OZONE PARK",
            "state": "NY",
            "postal_code": "114203717",
            "telephone_number": "631-379-6041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANTRY",
        "first_name": "SHAQUETTA",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-24",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "NY",
            "license": "339939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAQUETTA",
            "last_name": "TAYLOR",
            "middle_name": "A",
            "prefix": "MS.",
            "credential": "LPN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ortho-Bionics Laboratory, Inc.
• Stella Osagie-Omogun
• Manpreet Pabla, LPN
• Yasha Pandohie, OTR/L
• Charles J Pantina, R.PH.
• Adriana Parente, LMSW
• Park Diagnostics Laboratories LLC
• Park Health Pharmacy Inc
• Park Neurological Services, P.C.
• Salvatore Pavone, DMD

• Licensed Vocational Nurse in South Ozone Park, NY
• Providers in South Ozone Park, NY by specialty
• Licensed Vocational Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; 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.