Shija Elsan Eapen

Primary specialty

Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X

License

734787 Issued in NY

Practice address

23 Laurinda Dr
Commack, NY 11725-4503

Phone

(631) 386-8350

NPI assigned

Feb 5, 2018

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 identifiers 1

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": "1517788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630281600000",
    "number": "1821597972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 LAURINDA DR",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117254503",
            "telephone_number": "631-386-8350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 LAURINDA DR",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117254503",
            "telephone_number": "631-386-8350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EAPEN",
        "first_name": "SHIJA",
        "middle_name": "ELSAN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-05",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "NY",
            "license": "734787",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "50150",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Spencer F. Dubov, D.P.M.
• Lauren Dunn-Maloney, RD CDN
• Nicole Renee Dwyer, MS CCC-SLP
• Dynamic Counseling LCSW PC
• Eagle Vision Eye Care Corporation
• East Patchogue Podiatry P.C.
• Jayne Patrice Eaton-Bove, MS
• Edward Condon Medical PC
• Robert Christopher Edwards, LMSW
• Jennifer Ann Egan, M.A.

• Adult Psychiatric/Mental Health Registered Nurse in Commack, NY
• Providers in Commack, NY by specialty
• Adult Psychiatric/Mental Health Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2021; 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.