Individual provider Active NPI

Sherene Monifa McIntyre, F.N.P.

  • Family Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1174754949
Registry record updated Jul 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
335387 Issued in NY
Practice address
450 Clarkson Ave
Box 1274
Brooklyn, NY 11203-2056
Phone
(718) 270-3064
Fax
(718) 221-5761
NPI assigned
Jul 28, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 335387 NY Primary

Addresses

Primary practice location

450 Clarkson Ave
Box 1274
Brooklyn, NY 11203-2056

Mailing address

725 E 94TH St
Suite # 2
Brooklyn, NY 11236-1442
Phone (718) 926-5909

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
335387NYMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1248739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248739200000",
    "number": "1174754949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 E 94TH ST",
            "address_2": "SUITE # 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112361442",
            "telephone_number": "718-926-5909",
            "fax_number": "718-221-5761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 CLARKSON AVE",
            "address_2": "BOX 1274",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032056",
            "telephone_number": "718-270-3064",
            "fax_number": "718-221-5761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTYRE",
        "first_name": "SHERENE",
        "middle_name": "MONIFA",
        "credential": "F.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-28",
        "last_updated": "2009-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "335387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2009; 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.