NPIMap

Organization Active NPI

Queenshade LLC

  • Registered Nurse
  • Newark, NJ
National Provider Identifier
1558834069
Registry record updated Jan 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
Legal business name
QUEENSHADE LLC
Practice address
727 S 19TH St
Newark, NJ 07103-1032
Phone
(862) 576-3281
NPI assigned
Jan 8, 2019
Last updated
Jan 8, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2019

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

Authorized official

Name
Folashade Adebiyi, RN
Title
Supervisor
Phone
(862) 576-3281

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X Primary

Addresses

Primary practice location

727 S 19TH St
Newark, NJ 07103-1032

Mailing address

33 Rich St
Irvington, NJ 07111-2020
Phone (862) 576-3281

Other names 1

  • Queenshade Former legal business name

National Provider Directory

National Provider Directory
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.

NPI Registry JSON

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

{
    "created_epoch": "1546905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546905600000",
    "number": "1558834069",
    "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": "862-576-3281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 S 19TH ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071031032",
            "telephone_number": "862-576-3281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUEENSHADE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-08",
        "last_updated": "2019-01-08",
        "status": "A",
        "authorized_official_last_name": "ADEBIYI",
        "authorized_official_first_name": "FOLASHADE",
        "authorized_official_title_or_position": "SUPERVISOR",
        "authorized_official_telephone_number": "862-576-3281",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Queenshade",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2019; 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.