Queenshade LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

QUEENSHADE LLC

Practice address

1200 Clinton Ave Ste 100C1
Irvington, NJ 07111-2070

Phone

(862) 576-3281

NPI assigned

Jun 5, 2020

Last updated

Jan 12, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Folashade E Adebiyi, RN

Title

Director

Phone

(908) 656-4387

Specialties & licenses 1

Addresses

Other names 1

• Queenshade Other name

Electronic endpoints 2

Tax ID family

Queenshade3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Queenshade LLC

  • Registered Nurse
  • Newark, NJ
  • NPI 1558834069
  NPD tax ID
• Queenshade LLC

  • Supports Brokerage Agency
  • Irvington, NJ
  • NPI 1902615594
  NPD tax ID

Locations

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

{
    "created_epoch": "1591315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736640000000",
    "number": "1346864212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 RICH ST",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "071112020",
            "telephone_number": "908-656-4387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 CLINTON AVE STE 100C1",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "071112070",
            "telephone_number": "862-576-3281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUEENSHADE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-05",
        "last_updated": "2025-01-12",
        "certification_date": "2025-01-12",
        "status": "A",
        "authorized_official_last_name": "ADEBIYI",
        "authorized_official_first_name": "FOLASHADE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "908-656-4387",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "info@queenshade.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "www.queenshade.com",
            "address_1": "33 Rich St",
            "city": "Irvington",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "071112020",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "info@queenshade.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "www.queenshade.com",
            "address_1": "33 Rich St",
            "city": "Irvington",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "071112020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Queenshade",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Queenshade",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Community/Behavioral Health Agency in Irvington, NJ
• Providers in Irvington, NJ by specialty
• Community/Behavioral Health Agency in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 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.